GreyMatters
Educational articles, BetterBrain resources, latest in brain health, and news about us. Written for you, with expertise (and love).
Dietary Defenders: Prebiotic Fibers in Alzheimer's Prevention
As Alzheimer's disease continues to impact millions globally, the scientific community is increasingly focusing on the gut-brain axis. This complex communication network, which links the gastrointestinal tract and the brain, could play a major role in preventing cognitive decline. Recent discoveries1 have shown that gut microbiota might affect everything from brain development to behavior to disease states, and researchers are starting to explore how the gut-brain axis can influence dementia risk.
Exploratory study: A closer look at fiber's impact on aging brains
The School of Life Course & Population Sciences at King’s College London spearheaded a pivotal double-blind study2 (the same type of study as used for clinical trials) with participants over 60 years old. Their research aimed to uncover the cognitive effects of consuming prebiotic fibers compared to a placebo.
Fiber fuels cognitive fortitude
Like any organism, the components making up the gut microbiome need food to survive. One source of nutrients for them is prebiotic fibers, such as inulin and fructooligosaccharides (FOS), both of which were the focus of the King’s College study. The researchers found that participants who took prebiotic supplements had more of one species of healthy bacteria called Bifidobacterium in their gut. This species has previously been linked to better cognitive performance, and indeed the participants who took supplements showed improved cognitive function scores through the same memory tests that are used as an early indicator of Alzheimer’s disease.
Why is this happening?
The composition of the gut microbiome has drastically changed over human history. Advances in agriculture, industrialization and globalization may have caused a decrease in gut microbial diversity, which has been associated with worse health outcomes. In particular, a review of multiple studies1 suggests that changes in the microbiome can lead to behavioral changes. In another study3 comparing 25 patients diagnosed with Alheimer’s disease to 25 healthy individuals, those with Alzheimer’s were found to have reduced gut microbial diversity.
Keeping an eye on your intake
Let’s get specific. Women should aim to consume 21-25g of fiber per day. Men should aim for 30-38g4. Here is a list of some common fiber-dense foods to consider adding into your diet.
A promising path to cognitive health
Emerging evidence connecting dietary habits, gut microbiota, and brain function highlights a novel approach to combat Alzheimer’s disease. The gut-brain axis is still a new area of research - there is much we don’t know, and many researchers around the world are investigating the different ways in which the microbiome influences our brain health. Such studies not only pave the way for innovative therapeutic avenues but also emphasize the profound impact our diet can have on mental and overall health.
Putting the science in action
- Eat enough fiber each day to make sure you are nourishing your gut microbiome. Women should strive for 21-25g daily, while men should aim for 30-38g.
- Learn more about the importance of your gut health on your brain and body through the Peter Attia Drive podcast.some text
- Episode #215 goes in-depth on the GI system - skip to 34:30 for ways in which the gut and brain communicate, and to 1:55:00 for ways to promote your gut microbiome using your nutrition.
- Episode #283 discusses the microbiome specifically - learn more about the importance of fiber at 38:30 and about the gut-brain axis at 50:15.
Metabolic Syndrome as a Gateway to Dementia
It’s a well-known fact that Alzheimer’s disease is closely linked to metabolic health, to the point that some experts have begun to refer to it as Type III Diabetes. But what many people don’t know is that poor metabolic health is a strong risk factor for dementia long before it progresses to diabetes, even for people without a family history.
Decoding metabolic syndrome
Before you get diagnosed with diabetes, your body goes through a number of changes. Cells in your body become desensitized to insulin, which usually tells them to absorb sugar from your bloodstream. This results in chronically elevated blood sugar and in turn starts causing problems for your heart, liver, brain, and other organs. This pre-diabetic phase is called metabolic syndrome, and it affects ~25% of adults worldwide, including 40% adults aged 60+ in the U.S. Most of them do not know that metabolic syndrome is a health risk.
Metabolic syndrome is diagnosed when an individual has three or more of the following:
- High triglycerides (≥150 mg/dL)
- Elevated blood pressure (≥130 mmHg systolic or ≥85 mmHg diastolic) OR use of antihypertensive medication
- High fasting glucose (≥100 mg/dL OR use of glucose lowering medications)
- Low HDL cholesterol (<40 mg/dL in men; <50 mg/dL in women OR use of lipid-modifying medication)
- Abdominal obesity (waist circumference ≥102 cm for men and ≥88 cm for women)
It’s worth noting that hemoglobin A1c (HbA1c), a common marker for diabetes, does not feature on this list. Although a doctor won’t use A1c to diagnose metabolic syndrome, it’s still an important marker to keep track of your metabolic health.
Connecting metabolic syndrome to brain health
A large retrospective study1 analyzed data from 175,000 participants over a period of 15 years. Participants were aged 60+ and represented a variety of sociodemographic, lifestyle, and genetic backgrounds. With regards to the metabolic syndrome diagnosis criteria listed above, the study found that:
- Having three conditions increases dementia risk 12%
- Having four to five conditions is associated with an even stronger risk
- The link between metabolic syndrome and dementia is particularly strong in individuals who do not carry the APOE ε4 allele (typically, these are individuals with a lower risk of dementia)
Taking action
The first step is to know where you stand. It’s important to establish a baseline by measuring metabolic markers in your blood and potentially using a continuous glucose monitor (CGM) to see how your blood sugar reacts to your daily habits. This will help you make an informed decision on how to approach your metabolic health.
Metabolic health is strongly tied to your lifestyle - particularly your diet, physical activity, and sleep. There’s also several different drugs, like statins or ACE inhibitors, available to help manage symptoms. However, this post isn’t meant to serve as a meal plan or exercise sheet. Instead, we’ve put together a list of hacks that we think can make a difference even if you haven’t fully optimized your health.
- Drink a tablespoon of vinegar ~20 minutes before a meal. This helps avoid spikes in your blood sugar.
- Go for a walk after meals, especially if those meals are heavy on carbs (e.g., pasta, potatoes, bread). This helps your muscles absorb glucose more efficiently.
- Perform at least 10m of vigorous exercise per day. Raising your heart rate (e.g., through a short HIIT session) helps boost your insulin sensitivity, which keeps blood sugar low.some text
- Exercise is most effective at reducing blood sugar spikes when done within an hour before or after a meal
- Eat your carbs last. Start your meal by eating vegetables (which are high in fiber), then eating proteins and fats, and finally moving to carbs. This helps slow the absorption of sugar into your bloodstream, and in turn reduce sugar spikes.
Small steps add up
Although the hacks mentioned above aren’t meant to replace a healthy lifestyle, they can help you make an immediate improvement in your metabolic health and kickstart your dementia prevention efforts. Remember - working on your metabolic health isn’t just about preventing diabetes, it’s about safeguarding your cognitive health.
Actions to consider
- Measure your metabolic markers. Some of these you may get on your annual physical (e.g., HbA1c, HDL-C, LDL-C, glucose, triglycerides, insulin). Others are less common (e.g., Lp(a), ApoB). Most importantly, don’t settle for just ok. These markers are worth optimizing. All the tests mentioned above are part of the 50+ biomarkers tested during your BetterBrain Essentials blood draw.
- Consider using a CGM to get a more accurate view of how your body processes sugar. Using a CGM, you can observe the effects of what you eat and your lifestyle on your blood sugar in real time, which can help inform the daily choices you make. We love the Dexcom G7, which may be challenging to buy over-the-counter but can be bought for cheaper through Signos.
- Learn more about homocysteine on the Peter Attia Drive podcast #252. This episode covers a wide variety of topics related to brain health, and links many different risks and possible interventions to metabolic health.
Harnessing Heart Rate Variability for Brain Health
The intricate dance between our heart rate and brain function is more influential than we might think. Recent studies reveal that heart rate variability (HRV)—the measure of variations between individual heartbeats—affects our brain health, decision-making abilities, and even our emotional regulation. HRV is a physiological metric that we can train ourselves to improve, and its connections to the brain make HRV training a promising technique for dementia prevention and enhancing cognitive function.
Understanding the Heart-Brain Connection:
While your heart rate is the average number of beats per minute, HRV is the difference in length between individual heartbeats.
HRV is not just a measure of heart health - it reflects the health and balance of the autonomic nervous system (ANS), which is responsible for involuntary body functions. In particular, HRV serves as a key indicator of the interaction between the two components of the ANS: the sympathetic (fight or flight) and parasympathetic (rest and digest) nervous systems. Interestingly, there is a two-way feedback system between these nervous systems and the heart. The signals from the sympathetic and parasympathetic influence heart rate, and heart rate regulates the balance of these two systems. By exerting an influence on the ANS, heart rate variability helps regulate emotions and stress responses. In general, higher HRV is associated with better control over decision-making processes, emotional responses, anxiety, and social behaviors1.
Booting your HRV
Common HRV training protocols call for biofeedback, which is a fancy way of saying you need a sensor to measure your heart rate variability so you can improve it. HRV training involves guided exercises such as paced breathing while looking at real-time heart rate data to learn to consciously control heart rate variability. This is what makes it different from techniques like yoga or meditation - their focus is commonly to achieve a balanced state, whereas the goal of HRV training is to modulate physiological responses.
This technique not only promotes a balanced state but also has long-lasting effects on both mental and physical health. Thanks to the heart-brain connection, HRV training leads to improved emotional regulation and stress management. Although different training regimens exist, just five minutes of HRV training twice a day can significantly enhance control over the heart and reduce anxiety levels during stressful periods2. Critically, the benefits of HRV training extend far beyond mood and feeling: they also correlate with enhanced executive functions like planning, problem-solving, and resisting unhealthy impulses1. In fact, the benefits of this training can persist, with improvements seen even 12 weeks after stopping the training1.
Tying back to dementia
Thanks to its influence on stress response, cognitive function, healthy behaviors, and cardiac health, it’s no surprise that higher HRV is associated with stronger resilience against cognitive decline2,3. Since the simple daily practice of HRV biofeedback training can improve your HRV, we can think of it as a valuable tool to help delay the onset and progression of dementia. It's a clear testament to the power of our bodies' interconnected systems, and a reminder that taking care of our heart is as much about our mind.
Where to start with HRV training
- Choose a tracking device: the first step is to make sure you have the right equipment to measure your heart rate variability. Because you are measuring the time between individual heartbeats, you need a particularly sensitive device. Although some common wearables like the Apple watch or Whoop claim to measure HRV, it’s better to opt for a specialized chest strap like the Polar H10 which can connect to your other wearables.
- Visualize your data: once you have a solid device, use an app like Elite HRV or Welltory (both of which have a free version available) so that you can visualize your HRV in real time. These apps also come with a wealth of additional insights that can help you fine tune your training.
- Start training: you can find guided training sessions either through apps like Elite HRV or through online courses provided by organizations like the HeartMath Institute. YouTube also has a number of guided HRV routines you can try, such as this one from the Huberman Lab show.
- Learn more: The Peter Attia Drive podcast has an episode that dives deep into HRV so you can learn more about how it works and how it can help you.
Fighting Dementia with CBT: A proactive approach
Cognitive-behavioral therapy (CBT) has long been recognized as a powerful tool in managing mental health disorders, but its potential role in preventing dementia is only beginning to be appreciated1,2. There are two ways that CBT can help. First, CBT is a powerful tool which can combat anxiety, depression, and other mental health disorders, which increase the risk of dementia3,4. Second, CBT can be used to facilitate habit change - that is to say, help users adopt behaviors which promote brain health.
How does CBT work?
CBT is a structured form of psychotherapy that relies on the principle of identifying and changing certain thought patterns and behaviors. The underlying principle is that the brain is “plastic” or flexible throughout life, which means that we can shape the connections our brain makes. The therapy is collaborative, with the client and therapist working together to set goals and practice new skills. The specifics of a CBT session will vary depending on the needs of each individual, but sessions generally involve recognizing distorted thinking, challenging irrational beliefs, and developing healthier responses. CBT also encourages behavioral changes by gradually facing fears or engaging in positive activities.
CBT in Alzheimer’s prevention
Combating mental illness
Your mental health is closely linked to your brain health. Depression, anxiety, and other disorders can actually increase inflammatory stress in your brain and disrupt your cognitive function. There are several different approaches to treating mental illness, and CBT happens to be highly effective for some people.
Forming healthy habits
Much of dementia prevention relies on addressing known lifestyle risk factors, things like physical inactivity, poor diet, diabetes, and high blood pressure. Forming and maintaining healthy habits can feel challenging, but CBT can help facilitate behavior change and keep you on the right track.
Common CBT principles
Because CBT is a tool, many of its principles apply just as well to managing mental health as to improving lifestyle habits. Common techniques include:
- Awareness and Identification: CBT begins with helping individuals become more aware of their current state. What situations or thoughts trigger a negative cascade? Which of my habits aren’t the healthiest?
- Cognitive Restructuring: This is a fancy way of saying challenging negative thoughts. By examining negative emotions and thoughts, individuals can start to think about them objectively. For mental health, this can be changing “something catastrophic will happen” to “I can take on this challenge.” For habit formation, this may be replacing "changing my diet won’t make a difference" with "every healthy meal contributes to my resilience."
- Behavioral Experiments: CBT employs behavioral experiments to challenge negative beliefs and test out new behaviors in a controlled manner. This may look like gradually facing a feared situation, engaging in activities that carry a sense of accomplishment, or starting to exercise with 10-minute daily walks. The purpose here is to gain confidence and reinforce the challenge to negative thoughts with real-life actions.
- Goal Setting: Together with a therapist, individuals set specific, achievable goals related to their needs. These may be thing like developing problem-solving skills to improve their sense of control, or things like increasing weekly physical exertion. The most important thing is for these goals to feel realistic and manageable.
- Reinforcement: Positive changes are reinforced through self-monitoring and resilience techniques. Tracking change over time helps establish a feedback loop where improvement becomes a natural motivator, while practical skills for managing setbacks help sustain long-term behavior change.
By systematically working through these steps, CBT provides individuals with the tools and confidence to implement and sustain changes - many of which contribute to preventing dementia.
A strong tool for prevention
It’s important to recognize that CBT isn’t a silver bullet - it’s a tool that’s helped millions of people, and it requires conscious work to implement. With that said, the potential of CBT in preventing Alzheimer’s is vast. It not only helps address mental illness, but also incorporates lifestyle changes that tackle the physiological underpinnings of dementia. Implementing CBT strategies that promote healthy aging could be key in reducing the burden of dementia, emphasizing prevention over treatment and maintaining cognitive vitality well into the later years of life.
Resources on finding CBT providers
If you are interested in trying CBT, there’s several ways to get started.
- Online directories and telehealth platforms can help you find a professional to work with. You can often find therapists through your insurance plan or your employee benefits, or through listing websites like Zocdoc or Psychology Today. You can also look on telehealth platforms like Talkspace or Betterhelp, though not all of these accept insurance.
- Community health centers often also provide CBT services. These are typically available at reduced rates, and focus primarily on mental health.
- Books can help you learn more about CBT and its practice. Feeling Great: The revolutionary new treatment for depression and anxiety is a widely praised book by Dr. David Burns, a psychiatrist and professor of Psychiatry at Stanford.
Clearing the Air: How Pollution Influences Alzheimer's Risk
When you think of air pollution, respiratory disease is usually the first thing to come to mind. However, recent findings from the Emory Healthy Brain Study1 has begun to show that long-term exposure to tiny particles called PM2.5 has been associated with the accumulation of amyloid plaques in the brain, which is a hallmark of Alzheimer's disease. While this doesn't prove that PM2.5 exposure leads to Alzheimer's, it suggests a potentially elevated risk, especially among those exposed to poor quality air over longer periods of time.
Air quality is typically measured by the amount of specific pollutants in the air. The Emory Healthy Brain Study looked at a type of pollutant called PM2.5, which is fine particulate matter with a diameter of less than 2.5 micrometers (about 30 times smaller than a human hair). These particles are so fine they can bypass the body's airway defenses and enter the bloodstream. Common sources of PM2.5 include vehicle emissions, industrial combustion, and natural occurrences like wildfires. Because the particles can enter the bloodstream, they can cause health issues that go beyond simple respiratory irritation, potentially affecting brain health and contributing to cognitive decline.
Key Findings from the Study
- Increased PM2.5 exposure is associated with worse results on Alzheimer’s pathology biomarkers: The study indicated that higher levels of PM2.5 exposure over one and three years are associated with lower concentrations of amyloid-beta 42 (Aβ42) in cerebrospinal fluid (CSF). Aβ42 is a biomarker whose decreased levels suggest an accumulation of amyloid plaques in the brain, which is a hallmark of Alzheimer’s dementia.
- Specific Focus on Traffic-Related PM2.5: While the study looked at both ambient (general environmental) and traffic-related PM2.5, the findings were particularly noteworthy for ambient PM2.5. This suggests that while traffic contributes significantly to PM2.5 levels, other sources of pollution also play a crucial role in influencing Alzheimer’s disease biomarkers.
- Implications for Alzheimer’s Risk: The research underscores that even PM2.5 below levels currently considered risky by environmental standards, there is a tangible increase in the risk of developing Alzheimer’s disease. This calls for a reassessment of what is considered “safe” exposure to PM2.5, particularly for populations at risk of Alzheimer’s.
Reducing Exposure
Individuals living in high pollution areas can reduce their exposure by:
- Using air purifiers at home
- Avoiding outdoor activities when pollution levels are high
- Supporting clean air initiatives aimed at reducing emissions
Conclusion
The findings from Emory University’s research are a vital addition to our understanding of environmental factors in Alzheimer’s disease risk. They not only highlight the need for stricter air pollution controls but also suggest that everyday actions to reduce exposure to PM2.5 could be a feasible strategy for Alzheimer's prevention. As we continue to uncover more about the impact of our environment on health, it becomes increasingly clear that tackling air pollution is not just about preserving our planet—it's also about protecting our minds.
Saunas and Alzheimer's: Hot Topic or Just Hot Air?
For centuries, saunas have been lauded for their supposed health benefits, from improved cardiovascular function to detoxification. The recent trends around longevity seem to have revitalized the use of saunas, now considered a popular "health hack". But could spending time in these heated chambers also benefit your brain? Recent research suggests that sauna use might indeed play a role in mitigating the risk of Alzheimer's disease. In this article, we'll explore the scientific evidence behind this claim and consider how sauna use may impact your brain health.
The Connection Between Saunas and Alzheimer's Disease
The Finnish Study
A study from Finland has brought attention to the potential benefits of saunas for brain health. According to the 2,315 person study1, men who used a sauna 4-7 times a week showed a 65% reduced risk of Alzheimer's disease compared to those who used it once a week. Although the study mainly focused on men and thus requires further exploration for generalization, the findings are promising - 65% is a staggering number. If true, this would imply we could cut Alzheimer's prevalence from 6 million to 2 million in the US if only everyone used the sauna daily!
The Underlying Mechanisms
Scientists have proposed several mechanisms through which saunas may benefit the brain. One suggestion is that saunas can significantly improve sleep quality and time in deep sleep, which improves the brain's ability to clear toxic proteins. Moreover, heat stress activates heat shock proteins that can repair damaged proteins, which may play a role in neurodegenerative diseases like Alzheimer's. Lastly, saunas may improve various markers of vascular function, such as blood pressure and blood circulation, known risk factors for Alzheimer's.
Caveats and Considerations
First, the impact was more muted for those who used the sauna only 2-3 times a week (~22% risk reduction). Additionally, while the Finnish study shows a correlation, and certainly attempted to control for relevant variables, it is always very challenging to prove causation in retrospective studies.
Conclusion
The notion that saunas could "incinerate" your Alzheimer's risk is captivating, they should not be viewed as a standalone solution. While promising studies hint at a beneficial correlation, saunas are not a guaranteed prevention method for Alzheimer's. However, given their other health benefits and the intriguing data suggesting a potential role in brain health, saunas could be a worthwhile addition to your wellness routine. Plus, who doesn't enjoy an intense sauna session followed by a cold plunge or shower?
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GreyMatters
Grey Matters: What happens when brain health coaching actually clicks
The idea that changed everything
Exercise snacks. Short, two-minute movement breaks sprinkled throughout the day, designed to keep your body active and your brain engaged without requiring a gym, a plan, or even a change of clothes.
For Kate, who has ADHD and had always found traditional exercise routines overwhelming, this landed differently than most wellness advice. As she puts it, going to the gym always felt like too many steps, and even home workouts were hard to start. But the idea of standing up once an hour, moving for two minutes, and sitting back down? That felt doable. She built the habit into her coaching Action Plan, and those small bursts of movement started adding up across the day.
Then she started thinking bigger. What if someone is on an airplane and can't do floor exercises? What about people in wheelchairs, or people who are bed-bound and need gentle ways to stay active? What about someone in a professional setting who wants something more meditative, like tai chi? She kept imagining more situations, more people who could benefit, and eventually she thought: wouldn't it be great if there were an app built entirely around this?
So she built one herself
Kate had never written a line of code. She's comfortable with email, Google products, and Zoom, and that's about it. But she started watching YouTube tutorials on using AI to build apps, taught herself how to use a computer terminal along the way, and over the course of about a month designed, built, and shipped a fully functional app to the App Store.
The app is calledExercise Snacks for Health & Wellbeing, and it's free. It sends hourly movement reminders, offers exercises for different settings and mobility levels, and tracks your activity so you can watch those two-minute sessions add up across the day. She uses it herself every day, and she also published a companion book (free with Kindle unlimited).
Cognitive Engagement
Here's something worth noting: the process of learning to build the app may have been just as good for Kate's brain as the exercise snacks themselves. Research consistently shows that picking up unfamiliar, challenging skills is one of the most powerful ways to build cognitive reserve and support long-term brain health. It's why Learn is one of BetterBrain's 12 core brain health practices. Working through frustration, solving new problems, and learning something completely outside your comfort zone is exactly the kind of stimulation your brain thrives on. Kate came to BetterBrain looking for answers about movement and ended up giving her brain a workout in two completely different ways.
Why we wanted to share this
Because the science only matters when someone picks it up and does something with it. Kate worked with a coach, understood what her body and brain needed, and took one piece of her plan and turned it into something that could help thousands of other people move more throughout their day. That's exactly what this whole approach is designed to make possible.
Huge kudos to Kate. And hopefully her story inspires you to try something new, whether that's exercise snacks, a skill you've been putting off, or finally booking that first coaching session.
Know someone who might benefit from BetterBrain?
Share this referral link and they'll get Essentials labs (50+ biomarkers) for just $39 (normally $89), plus access to $0 coaching with insurance.
Grey Matters: One coach’s most effective brain health strategies
Meet Sarah Ferreira, MS, MPH, RD, IFNCP: Brain Health Coach
Sarah Ferreira, MS, MPH, RD, IFNCPis an integrative and functional dietitian with dual master's degrees in Nutrition and Public Health, plus additional training in applied neuroscience and brain health. Her clinical interests include dementia prevention, neurological conditions, thyroid and digestive health, and the psychology of eating behavior.
Sarah's career spans inpatient clinical nutrition, eating disorder treatment, community nutrition with WIC, and 1:1 and group work at the Cleveland Clinic Center for Functional Medicine. She's passionate about helping people build confidence through knowledge and celebrating strategic successes over time.
Outside of her professional life, Sarah can often be found with a stack of library books, at a flamenco dance class, or spending time outdoors with her young son. She believes the fullest life is best lived with strong black coffee, flavorful curries, and mango in just about any form.
Sarah's Top Recommendations
Her new favorite brain health technique:
"My new favorite brain health technique is supplementing with Magnesium L-Threonate, a form of magnesium with some evidence of the ability to cross the blood brain barrier more efficiently than other types. I love it because it supports clearer thinking, better focus, and a calmer nervous system without feeling sedating. It's become a simple daily ritual that I plan to keep!"
Here's one of our favorite magnesium picks.
A simple strategy that's been especially effective for clients:
"Sleep troubles are so frustrating, and make it much more difficult to focus, maintain healthy blood sugar, and keep energy levels up. A simple strategy I've been talking about with clients who struggle with sleep is lowering the room temperature at night.
As bedtime approaches, core body temperature should drop; a cooler environment reinforces this process and signals the brain that it's time to wind down. Sleeping in a cooler room, typically around 60 to 67°F, has been shown to promote deeper slow wave sleep and reduce nighttime awakenings. A cooler setting can also prevent overheating, which is a common disruptor of REM sleep. Altogether, adjusting the thermostat is a simple, evidence aligned way to improve both the depth and consistency of your sleep."
A mindset shift that makes a big difference:
"Shifting away from 'ideal or nothing' thinking can be incredibly freeing and supportive of long term success. When clients think in extremes like 'I need to be at the gym for 45 minutes in order to exercise,' or 'If I can't do this perfectly, it's pointless,' I encourage them to think about the next best step and adopt a mindset of purposeful experimentation as they try out new things.
Over time and with consistency, small wins accumulate and foster self compassion, shape our sense of self, increase motivation, and create a positive sense of control over our brain health."
Her go-to brain boosting ritual:
"My go to brain boosting ritual is early morning movement. In the winter, I notice the best benefits for mood and mental clarity with a challenging Pilates session, weight lifting, and indoor cycling. It feels like a major win if I can get it done before my toddler wakes up!"
What she's most excited about in brain health research:
"I'm really excited about the ongoing accumulation of evidence around nutrition and brain health. Studies increasingly show that long term, nutrient dense eating patterns can support memory, focus, and even slow age related cognitive decline. Key nutrients like omega 3 fatty acids, antioxidants, and choline appear to protect neurons, reduce inflammation, and support healthy brain signaling.
What I find especially uplifting is how practical and adaptable these findings are, both for personal habits and for guiding clients. Framing food as a tool for cognitive resilience makes healthy eating feel meaningful and empowering, rather than restrictive."
Content Corner
Huberman Lab: Nutrients For Brain Health & Performance
Bottom line: This Huberman Labs episode is a practical companion to what Sarah shared about nutrition and brain health. Dr. Andrew Huberman, Stanford neuroscientist, breaks down the specific nutrients proven to support brain function, both for immediate cognitive performance and long term brain health.
The episode covers ten science supported tools, starting with the fact that fat is the most important element for brain function because it provides the structural building blocks for neurons. Huberman explains that omega 3 fatty acids, particularly DHA, are essential for brain health, with foods like salmon, mackerel, and sardines being top sources. He recommends 1.5 to 2 grams of DHA daily for those not consuming enough fish.
Beyond omega 3s, he dives into choline (500mg to 1g daily), which supports focus by providing the substrate for acetylcholine, a key neurotransmitter. He also covers anthocyanins from blueberries (60 to 120 grams of fresh berries daily has been shown to enhance cognition in older adults), phosphatidylserine for reducing cognitive decline, and creatine for brain energy, particularly beneficial for those who don't eat meat.
The key insight? Huberman emphasizes that the goal is to get proper nutrients via food first, then use supplements as a backup. He also explores something fascinating: how we can actually rewire our food preferences toward healthier choices by understanding the gut brain connection and the psychology of taste. Our brains can learn to crave the foods that are good for us.
BetterBrain Takeaway:The nutrients Huberman highlights, omega 3s, choline, and antioxidants, are exactly the ones Sarah mentioned being excited about. Whether you're looking to optimize focus now or protect your brain for the long term, this episode offers specific, actionable guidance on what to eat and how much.
Grey Matters: What Sardinians can teach us about brain health
What Makes Sardinia Special
Sardinia is one of five validated Blue Zones, geographically defined areas with disproportionately high concentrations of people living past 100. The others are Okinawa (Japan), Nicoya (Costa Rica), Ikaria (Greece), Loma Linda (California), and Singapore (the most recent addition).
What makes Sardinia particularly fascinating is the male-to-female centenarian ratio: approximately one-to-one, unlike most populations where women vastly outnumber men among centenarians. This gender parity suggests environmental and lifestyle factors, not just genetics, drive exceptional longevity.
The Mediterranean Diet: What the Science Shows
The Mediterranean dietary pattern is central to Blue Zone longevity. Here's what actually matters:
Olive oil is the cornerstone. Extra virgin olive oil is linked to improved cognitive function and a lower risk of cognitive decline in elderly populations. The magic is in the polyphenols, compounds that reduce lipid peroxidation and increase cellular glutathione, enhancing protection against oxidative damage.
Fish and omega-3s provide neuroprotection. Omega-3 fatty acids abundant in fish and nuts have powerful anti-inflammatory properties. Mediterranean populations eat fish multiple times weekly.
Plant-based foods deliver antioxidant firepower. Vegetables, fruits, and whole grains are rich in flavonoids and bioactive compounds with antioxidant and anti-inflammatory properties.
Coffee and tea matter too. A recent JAMA study of 131,821 participants over up to 43 years found higher caffeinated coffee intake was associated with 18% lower dementia risk, with the sweet spot at 2-3 cups daily. Notably, decaffeinated coffee showed no protective effect, suggesting caffeine itself provides neuroprotection.
The complete lifestyle formula: Sardinians don't just eat well. They engage in constant movement through shepherding, farming, gardening, and walking rather than isolated gym sessions. They remain close with friends and family throughout their lives, gathering to laugh together. Laughter reduces stress, which can lower cardiovascular disease risk.
The diet works through multiple mechanisms, exerting protective effects through vasoprotective and neuroprotective pathways that deliver anti-aging benefits to both vascular cells and central nervous system cells. It counteracts mitochondrial dysfunction, oxidative stress, and chronic inflammation (the cellular processes driving brain aging).
Experience Sardinia's Secrets Firsthand with Dr. Annie Fenn
Dr. Annie Fenn is a physician, chef, and leading voice in brain-health nutrition. Through her Substack and bestselling book Brain Health Kitchen, she's made the science of brain-protective eating accessible and delicious for thousands of people. Her approach combines rigorous research with practical cooking techniques, making Mediterranean dietary patterns achievable in everyday life.
This October 12-18, 2026, Dr. Fenn is leading Sardinia's Secrets for a Long and Healthy Life, an immersive retreat in one of the world's original Blue Zones.
Set on the island of Sardinia, this experience blends science-backed education with pure Italian joy: trekking and e-biking, olive oil tasting, cooking with locals, and unforgettable meals rooted in the traditional Mediterranean pattern.
Along the way, you'll be learning practical tools from Dr. Fenn that you can apply to your own brain-healthy lifestyle back home. Learn more and reserve your spot here, or call 877-298-9677.
We're huge supporters of the impact Dr. Fenn is having in the brain health community. Her science-backed techniques align with what we believe about prevention and personalized nutrition. That's why we're thrilled to be a founding sponsor of her new podcast,The Brain Health Kitchen Podcast.This season features BetterBrain's own co-founder Cedric Gousseau, Chief Science Officer, Dr. Tommy Wood, and brain health coach Barbie Boules, among other guests, sharing their expertise on brain-healthy nutrition and lifestyle.
What You Can Do
You don't need to move to Sardinia to benefit (although Dr. Fenn's retreat seems like the perfect compromise). Here's how to implement these patterns on your own:
Build your diet around Mediterranean staples:
Use extra virgin olive oil as your primary fat (2-4 tablespoons daily). Eat fish 2-3 times weekly (salmon, sardines, mackerel). Fill half your plate with vegetables and fruits. Choose whole grains, beans, and legumes. Limit red meat to a few times monthly. Enjoy 2-3 cups of coffee or 1-2 cups of tea daily.
Move constantly: Take walking meetings. Use stairs, garden, cook from scratch. Build activity into daily tasks rather than treating exercise as something separate from life.
Prioritize social connection: Share regular meals with family and friends. Maintain multi-generational relationships. Laugh regularly.
Explore brain-healthy nutrition in your BetterBrain Dashboard. Get personalized guidance on implementing Mediterranean dietary patterns based on your biomarkers, genetics, and health goals.
Bottom Line
Sardinian longevity is about comprehensive lifestyle: Mediterranean dietary patterns rich in olive oil, fish, and plants; constant movement; deep social connections; and purpose. The evidence is strong, the mechanisms are understood, and the principles are implementable today.
Ready to live like a Sardinian and build your brain health foundation? BetterBrain helps you identify and implement the dietary and lifestyle interventions that matter most for your biology. Our coaches create personalized protocols based on your biomarkers, genetics, and health goals.
Grey Matters: The four Essential Techniques our coaches keep recommending
Move Practice: The post meal walk
Maggie works with clients across the metabolic-health side of our client base. The trend she keeps seeing: HbA1c and fasting insulin numbers creeping into pre-diabetic ranges, often without the client realizing it. Many of them are exercising, but most of them are not walking after meals.
"Ten minutes after each meal. That is the rule I get the highest compliance on, because nobody can argue they don't have ten minutes. And it does more than people expect."
The evidence behind post meal walks is broad and the bar to entry is low. A short walk after eating blunts the post-meal glucose spike. Repeated over months, it is one of the most reliable ways we have seen to shift HbA1c, fasting insulin, and the metabolic conditions that drive midlife brain atrophy. The cost is nothing, the schedule disruption is minimal, and the long-term payoff compounds. It is essential because it works for almost everyone.
Sleep Practice: Consistent wake time and morning light
Emily works with a large share of our clients who came to BetterBrain because of family history of dementia. The trend she keeps seeing: anxious clients arriving with long supplement lists, wanting to talk about pTau-217 and APOE4, while sleeping six or fewer hours a night.
"One night of four hours isn't really the question. The question is why someone is typically sleeping four or five hours at most. Patterns matter. What we identify from the first visit and where we end up is more than one night of poor sleep. Sleep is the foundation. Exercise goals, stress management, eating, they all land once sleep patterns are optimized."
The Essential Technique Emily points to first is in our Sleep Practice: a consistent wake time paired with morning light. The reason this is essential for almost everyone is the glymphatic system. Sleep is the period during which the brain runs its only clearance system, including the clearance of amyloid. A consistent wake time anchors the circadian rhythm, and morning light reinforces it. The evidence is strong, the intervention is free, and it works for clients in their 30s and their 70s.
Move Practice: Strength Training
Wendy works with many of our clients in their late fifties and sixties. The trend she keeps seeing: clients who are doing aerobic exercise faithfully, often three or four days a week, and skipping strength training entirely.
“I’m flexible with many aspects of a health plan, but strength training is one area I strongly encourage people not to overlook. The research connecting muscle mass and brain health after 50 is incredibly compelling, and maintaining strength now can have a major impact on long-term health and quality of life.”
Strength training is another Essential Technique in our Move Practice. The reason it is essential, not optional: muscle is the primary site of glucose disposal in the body, the pathways linked to neurogenesis are responsive to resistance training, and sarcopenia is one of the strongest predictors of cognitive decline in older adults. The evidence supports two sessions a week, moderate intensity, sustained for at least six months. Bodyweight work and resistance bands are enough to start. The technique is essential because everyone past 30 is slowly losing muscle, and the cost of skipping it is too high.
Supplement Practice: Methylated B Vitamins
Another trend we keep seeing across our client base: people arriving with homocysteine in the 11 to 14 range, told by their primary care that it is fine. The gap between what is flagged at most labs and what is optimal for brain health is one of the cleanest examples of where our framework differs from standard care.
The optimal range for homocysteine is under 9 μmol/L. Most labs flag a result only above 15. The 9 to 14 range is where a meaningful number of clients are quietly carrying elevated risk that has been waved off. A methylated B-complex moves the marker for the majority of clients within three months, and the cognitive payoff is real.
The Essential Technique in our Eat Practice is targeted methylated B-complex supplementation. The reason this is essential for almost everyone has to do with the underlying biology. Homocysteine is cleared through methylation pathways that depend on the active forms of folate, B12, and B6. A significant portion of the population carries variants of the MTHFR gene that reduce how well the body converts standard folic acid into the active form.
Methylated B-complexes deliver the active forms directly. For anyone over 40 thinking about long-term brain health, this is one of the highest-leverage interventions available.
What the pattern reveals
Across our coaches with different specialties and different client populations, the same Essential Techniques keep coming up. These are the techniques that consistently move the needle, regardless of who is doing them. What our coaches actually do day to day is build action plans that span the full technique library: prioritizing among the Essentials and layering in the context-dependent techniques that fit each client’s panel and life.
The Essentials are universal. The action plan is personal.
If you are thinking about long-term brain health, the Essential Techniques are the highest-leverage place to start. They are the techniques our clinical advisors backed because the evidence is strong and they work for almost everyone.
If you’d like a quick read on which Essential Techniques to prioritize based on what you are already doing, take the free Essential Scan. Open to anyone, whether you’re already a BetterBrain client or just starting.
If you’d like a deeper personalized action plan, BetterBrain coachingpairs you with a Brain Health Coach who builds the plan with you based on your biology and lifestyle.
How to Personalize Your Brain Health Plan With Your Own Data
How to Personalize Your Brain Health Plan With Your Own Data
Most brain health advice is useful, but it is also designed for the average person.
Sleep more. Move often. Eat a nutritious diet. Manage stress. Build strength.
These fundamentals matter. But they cannot tell you which risk factors deserve the most attention, what may be changing in your body, or whether your current routine is producing the results you want.
Personalized brain health guidance uses your own labs, health history, sleep, activity, habits, and goals to help determine where to focus first.
BetterBrain members can now bring more of that information into My Vault, the health data home inside the BetterBrain platform. You can upload previous lab results, connect wearable data, and import relevant health context from an AI assistant such as ChatGPT, Claude, or Gemini.
All three tools are available free across BetterBrain accounts.
Why Does Generic Brain Health Advice Have a Ceiling?
General health advice tells you what tends to help people on average. It cannot tell you which intervention is likely to matter most for you.
Two people can follow the same routine and have very different needs because they begin with different:
- Biomarker levels
- Genetics and family histories
- Sleep patterns
- Activity levels
- Medical histories
- Medications and supplements
- Diets, habits, and goals
One person may need to focus on improving sleep consistency. Another may already sleep well but have an elevated cardiovascular risk marker that deserves more attention. A third may be exercising regularly but not recovering adequately.
That is why personalization matters. It helps turn broad recommendations into clearer priorities.
Research has also found that multidomain brain health interventions tailored to individual risk profiles can produce better cognitive outcomes than general health information alone. You can read the randomized controlled trial published in Nature Medicine here.
What Is Personalized Brain Health Guidance?
Personalized brain health guidance applies current research to information about your own health.
Instead of simply telling everyone that sleep is important, personalized guidance can consider:
- How much you are actually sleeping
- Whether your sleep duration or consistency is changing
- How your sleep relates to your activity and recovery
- Whether your current protocol appears to be helping
- Which other risk factors may deserve attention
Personalization does not replace the fundamentals. It helps identify which fundamentals matter most for you, where to begin, and what to monitor over time.
How Does My Vault Help Personalize Your Brain Health Plan?
My Vault brings several sources of health information together inside your BetterBrain account.
You can use it to:
- Upload previous laboratory results
- Connect sleep and activity data from a wearable
- Import relevant health context from another AI assistant
Together, these tools give BeBe, BetterBrain’s AI brain health coach, a more complete picture of your health and goals.
Upload Past Lab Results and Track Changes Over Time
A single laboratory result is only a snapshot. The trend often provides more useful context.
If you have previous results stored in a patient portal, computer folder, email, or paper file, you can upload them to My Vault as a PDF or image. BetterBrain can extract the biomarker results and display them alongside your current numbers.
Tracking results over time can help you understand:
- Whether a biomarker is moving in the desired direction
- Whether a change is new or part of a longer pattern
- How your results respond to changes in your routine
- Whether an intervention appears to be working
- Which markers may deserve further discussion with your clinician
For example, a cholesterol result may appear acceptable when viewed alone. But seeing several years of results together could reveal that the number has been steadily increasing or improving.
Your brain health plan should respond to what is changing, not just what appeared on one test.
Link Your Wearable Data
Questionnaires capture what you remember. Wearables can capture what is happening each day.
If you use a fitness tracker or smartwatch, you can connect it to BetterBrain through the BeBe app and Apple Health. You choose which information you want to share, and you can change the permissions or disconnect the integration at any time.
Depending on your device and permissions, wearable data may provide useful context about:
- Sleep duration
- Sleep consistency
- Daily movement
- Exercise
- Heart rate
- Recovery patterns
- Changes in routine
This can make guidance more specific.
Instead of receiving another reminder that sleep is important, you may be able to see that your sleep duration is adequate but inconsistent, or that your activity has declined over the past several weeks.
The goal is not to obsess over every daily number. It is to recognize meaningful patterns that may otherwise be easy to miss.
Import Your AI Memory
Many people already use ChatGPT, Claude, or Gemini to discuss their health, routines, goals, and preferences.
You may have already told an AI assistant about:
- Your health history
- Current symptoms or concerns
- Injuries
- Medications and supplements
- Family medical history
- Exercise habits
- Diet
- Sleep
- Health goals
- How you prefer advice to be delivered
- Strategies you have already tried
You can now bring that context into BetterBrain instead of starting from the beginning.
Visit Import AI Memory inside My Vault. You will see a prompt that you can open or paste into the AI assistant you use. The assistant will organize the relevant information it knows about you. You can then review the response and paste it into BetterBrain.
The process takes about a minute.
Once imported, BeBe can begin with more context about your history, preferences, goals, and previous efforts.
How Is BeBe Different From ChatGPT, Claude, or Gemini?
General AI assistants draw from broad knowledge across an enormous range of subjects. Their responses are also largely shaped by what you choose to tell them in each conversation.
BeBe is built specifically for brain health. It is grounded in brain health research that has been reviewed and interpreted by BetterBrain’s scientists and clinicians.
BeBe can then apply that specialized knowledge to information within your BetterBrain account, including:
- Your laboratory history
- Wearable sleep and activity data
- Health profile
- Current brain health protocol
- Uploaded documents
- Coaching insights
- Imported health context
- Personal goals and preferences
The distinction is specialized brain health science combined with your personal data.
A general assistant may repeat common recommendations. BeBe is designed to help you understand how the evidence relates to your own risks, results, and priorities.
Is My Health Information Private?
Your imported information stays private to your account and is used to personalize your guidance.
You control what you upload, what wearable information you share, and whether you want to delete information later. Wearable permissions can also be changed or turned off at any time.
Only import information you are comfortable storing in your BetterBrain account.
How Do I Get Started With My Vault?
You do not need to complete everything at once.
Start with whichever option is easiest:
- Upload one previous lab report.
- Connect your wearable through the BeBe app and Apple Health.
- Import relevant health context from ChatGPT, Claude, or Gemini.
- Review your health profile and current protocol.
- Ask BeBe what patterns or priorities stand out.
All three personalization tools are available with a free Self Directed BetterBrain account.
Members who want to go further can also purchase laboratory testing through Blueprint or enroll in the BetterBrain Coaching Program.
Frequently Asked Questions About Personalized Brain Health Guidance
What is personalized brain health guidance?
Personalized brain health guidance applies scientific evidence to information about your individual labs, health history, sleep, activity, habits, risk factors, and goals. It helps identify which actions may deserve the most attention for you.
What is BetterBrain My Vault?
My Vault is the health data home within your BetterBrain account. It allows you to upload lab reports and other files, complete your health profile, record your current protocol, connect wearable data, and import relevant health context from another AI assistant.
Why should I upload previous lab results?
Previous results help establish a trend. Comparing multiple tests over time can show whether a biomarker is improving, worsening, or remaining stable.
What wearable data can BetterBrain use?
Available data depends on your device and Apple Health permissions. It may include sleep, activity, exercise, heart rate, and other daily health metrics.
Can I control which wearable information I share?
Yes. You choose which Apple Health categories to share and can update your permissions or disconnect the integration later.
What does importing AI memory mean?
Importing AI memory means asking ChatGPT, Claude, or Gemini to summarize relevant information it already knows about your health, preferences, habits, and goals. You can review that response before pasting it into BetterBrain.
Does BetterBrain automatically access my ChatGPT or Claude conversations?
No. You choose what to export, review the response, and manually paste it into BetterBrain.
How long does it take to import AI memory?
The process typically takes about a minute. BetterBrain provides a prompt that helps your existing AI assistant organize the relevant information.
Are the My Vault personalization tools free?
Yes. Uploading previous labs, connecting wearable data, and importing AI memory are available across BetterBrain accounts, including free Self Directed accounts.
Does BeBe replace a doctor?
No. BeBe provides educational brain health guidance and helps you understand your data and potential priorities. It does not replace medical diagnosis, treatment, or care from a licensed healthcare professional.
The Glymphatic System: Why Deep Sleep Is Your Brain's Best Cleanup Tool
Featured System: How Your Brain Takes Out the Trash
Every other tissue in your body has lymphatic vessels to carry away metabolic waste. For a long time the brain was thought to be the exception, with no obvious plumbing for the job. That changed in 2013, when researchers described what’s now called the glymphatic system: a network that uses cerebrospinal fluid to flush waste out of brain tissue, including amyloid-beta and tau, the proteins that accumulate in Alzheimer’s disease.
The finding that reshaped how we think about sleep came alongside it. Glymphatic clearance is not constant. It ramps up dramatically during deep, slow-wave sleep, when the spaces between brain cells expand and fluid can move through more freely. This is one of the clearest biological reasons that sleep is not optional maintenance. It is when a specific, measurable cleanup process actually runs.
So the existence of the system is well established. The question researchers have kept working on is mechanical: what physically moves the fluid?
What the newer research adds
A 2025 study in Cell from Maiken Nedergaard’s group (one of the labs behind the original glymphatic work) helps answer that question. In mice, the team showed that during deep sleep a small brainstem region called the locus coeruleus releases norepinephrine in slow, rhythmic waves, roughly one every fifty seconds. Each wave gently tightens and relaxes the blood vessels, and that slow oscillation appears to act like a pump, driving cerebrospinal fluid through the brain to move waste along.
It’s an elegant result because it connects three things we already knew were related (deep sleep, blood-vessel tone, and fluid clearance) into a single mechanism. It reframes deep sleep not as the brain idling, but as the brain running a coordinated pump.
Two points of rigor worth keeping straight, because they change how much weight any single study can carry:
- This is animal research. The norepinephrine-wave mechanism has been demonstrated in mice, whose sleep biology is a strong but imperfect model for ours. It tells us how the system likely works; it is not a human clinical trial.
- And the same study raised a careful question about sleep medication. The researchers found that zolpidem (the active ingredient in Ambien) suppressed these norepinephrine waves in mice and reduced fluid flow. That is a genuinely interesting signal, but it is a finding in animals about a mechanism, not evidence that a prescription harms people. If you take a sleep aid, this is not a reason to stop. It is a reason to make the underlying sleep quality a real conversation with your doctor.
Bottom Line: The glymphatic system and its dependence on deep sleep are well established. The newer work gives us a plausible engine for it, the slow norepinephrine rhythm of deep sleep, and a reminder that how you sleep, not just how long, is what lets the system do its job.
What this means for you
None of this requires a new gadget or supplement. It reinforces the fundamentals, and gives you a sharper reason to take them seriously.
Protect the deep-sleep window. Slow-wave sleep is concentrated in the first half of the night. A consistent wake time, morning light exposure, and a cool, dark room are the most reliable ways to protect it.
Be honest about alcohol and late meals. Both fragment the deep-sleep stages where clearance is most active. You may fall asleep fine and still lose the part of the night that matters most here.
Treat sleep as something you can measure. The same way we track a biomarker, sleep consistency and quality are worth paying attention to over time rather than guessing at.
Take loud snoring or daytime exhaustion seriously. These can signal sleep apnea, which repeatedly interrupts the deep sleep this system depends on, and it is both common and treatable. It’s worth flagging to a clinician.
Keep prescriptions in your doctor’s hands. If you use a sleep medication, bring the goal of better sleep quality to your prescriber rather than changing anything on your own.
Your BetterBrain coach can help you turn any of this into a specific, trackable Sleep Practice rather than a vague intention to "sleep better."