Ask the Pros Q&A

Q: What lifestyle measures can I take to protect my brain from dementia?

In researching this question, I looked at the work of neuroscientists Drs. Dean and Ayesha Sherzai. Their NEURO protocol is based on the latest research pertaining to the prevention of brain diseases such as dementia which includes Alzheimer’s disease. There is a “tsunami” of dementia that is appearing to worsen in the Western world. Alzheimer’s disease (AD) is the fastest-growing epidemic in the Western world. In the United States, it is the leading cause of morbidity and it is currently listed as the fourth leading cause of mortality.

Dementia affects 1 in 10 individuals older than 65 years and increases to 50% of all people older than 85 years. The prevalence of Alzheimer’s dementia, the most common form of dementia, has been increasing rapidly and is projected to reach 16 million individuals by the year 2050. One prevailing myth surrounding dementia is that it is exclusively a genetic disease and is inevitable. Several prevailing myths about the science of dementia are discussed, such as that Alzheimer’s is inevitable and that it is exclusively a genetic disease. While Alzheimer’s is not reversible, Drs. Sherzai report that 90% of Alzheimer’s cases can be prevented.

Lifestyle change can significantly alter the course of Alzheimer’s. The Sherzais have created an acronym—NEURO—to help people remember the most important lifestyle elements in the treatment and prevention of Alzheimer’s based on the evidence. “N” is for Nutrition, “E” for Exercise, “U” for Unwind (stress management), “R” for Restorative Sleep, and “O” for Optimizing mental and social activity. We will discuss each of these elements below.

Nutrition: What we eat every day has a significant impact on brain health. A whole food plant-based diet is optimal for preserving brain health and potentially avoiding Alzheimer’s. Nutrition recommendations include:

  1. Reduce processed sugars
  2. Reduce fats, especially saturated fat
  3. Reduce animal products (meat, dairy, cheese)
  4. Reduce processed foods
  5. Consume more plants of all varieties, especially greens and beans
  6. Increase fruit consumption, especially berries
  7. Reduce salt consumption

Exercise: Numerous studies have shown that aerobic exercise can improve a number of aspects of brain health including cognition and performance. The data have revealed the incredible curative and regenerative effect of exercise with regards to the brain.

The type of activities that have been found to be most beneficial for brain health and potentially contribute to the reversal of cognitive impairment include the following:

  1. An exercise program that involves regular, fairly extensive aerobic exercise (try to work up a mild sweat)
  2. Leg strengthening exercises
  3. Regular movement throughout the day

Unwind: Stress decreases the level of BDNF (brain-derived neurotrophic factor), thereby inhibiting the growth of new neurons and connections. Some stress is good such as learning a new activity or language. Bad stress such as worry about life situations, depression, and anxiety are associated with poorer outcomes. Controlling bad stress is incredibly important to preventing brain disease. Meditation has been associated with reduced brain atrophy, greater neuroplasticity, and improved cognition.  Research points to several important takeaways to stress management:

  1. Identifying one’s good and bad stress
  2. Working toward increasing good (purpose-driven, success-oriented) stress and reducing bad stress
  3. Including meditation and mindfulness techniques throughout the day.

Restore: Restorative sleep is essential for promoting brain health. Sleep serves 2 extremely important functions: (1) help organize and consolidate memories and thoughts and (2) detox the brain from all the day’s cumulative inflammatory, oxidative, and waste by-products.

What we know to date about sleep and its effect on the brain include the following:

  1. 7 to 8 hours of restorative sleep is optimal. Sleep also involves going through deep sleep through the different phases of sleep several times per night;
  2. Restorative sleep leads to memory and cognitive consolidation and organization as well as detoxification;
  3. Almost everyone can achieve ultimate restorative sleep through consistent sleep hygiene implementation (avoiding use of devices at night, going to bed at the same time every night, waking at the same time every morning, avoiding caffeine, and eating too close to bedtime)
  4. If one suspects the possibility of sleep apnea, he or she should immediately get tested for it because untreated sleep apnea and other sleep disorders can significantly increase one’s risk for dementia.

Optimize: Optimizing these lifestyle factors can reduce one’s risk for developing dementia significantly, especially if started earlier in life. Implementing complex real-life activities around one’s passion and purpose, such as challenging jobs, learning musical instruments, and speaking multiple languages, are most effective in optimizing mental processes and building cognitive reserve and brain capacity.

Optimizing your brain appears to be most effectively achieved when:

  1. People are involved in complex tasks (involving multiple cognitive domains of the brain), such as learning musical instruments, learning languages, and leading projects; task or job complexity has an even greater impact on building a cognitive reserve
  2. Activities are challenging, thus continually pushing the brain to adapt
  3. Activities are purpose-driven—this creates positive stress for the brain

Although these 5 lifestyle factors are central to protecting the brain, there are many others that have been shown to influence our risk for developing AD. Two major factors include smoking and alcohol abuse. Another major contributor to increased risk for dementia is a history of traumatic brain injury.


Sherzai, D., & Sherzai, A. (2019). Preventing Alzheimer’s: Our Most Urgent Health Care Priority. American journal of lifestyle medicine13(5), 451–461.

Slavich GM, Irwin MR. From stress to inflammation and major depressive disorder: a social signal transduction theory of depression. Psychol Bull. 2014;140:774-815.

Hampel H, Prvulovic D, Teipel S, et al.; German Task Force on Alzheimer’s Disease (GTF-AD). The future of Alzheimer’s disease: the next 10 years. Prog Neurobiol. 2011;95:718-728.

Contributing Writer: Erin Sinnaeve APN, FNP-C

Erin Sinnaeve is a Family Nurse Practitioner, a member of the American College of Lifestyle Medicine, and owns her own private health coaching business Thrive Plant Life. She also works in Allergy/Immunology at Advocate Aurora Health.

Erin received her BSN from University of Nebraska, her MS from Creighton University, and her DNP from Chamberlain University. She is an instructor at Chamberlain University, a Food Over Medicine instructor and a member of the Physicians Committee for Responsible Medicine.