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What's causing these ‘Senior Moments’ in my forties?



More than 70% respondents said they began to experience brain fog after reaching their forties
Source: www.instagram.com/ciara.ryannt

I ran a poll recently on my Instagram account asking followers when they started to experience brain fog (What is it you ask! You know when you walk into a room and can’t remember why you’re there, or you can’t recall the simplest of details? Yes? That’s Brain Fog)!


More than 70% of the respondents said it was after they reached their 40’s, which honestly did not surprise me. So many of my clients in this age group report having memory issues. Which can be a scary thought, particularly when there’s a history of dementia in the family.


Firstly let me put your mind at ease as there is a perfectly logical (and scientific) explanation of why you might be experiencing forgetfulness.


As is the case during childhood, puberty, pregnancy and postpartum, Perimenopause is a time of changes to the brain. During all those periods in our life the brain recalibrates, which to use a computer analogy, is like a software update.


So, during our perimenopause (which is sometimes referred to as the second puberty) we undergo somewhat of a neurological transition. During this period many women go through some degree of cognitive decline. This might sound scary but rest assured that for most it’s temporary.


So, if you find yourself walking into a room with no idea what you came in for or losing your car keys several times a day, you’re not going crazy or losing the plot (even though it can sometimes feel like this)! Women can often struggle at this time with things like recalling details, remembering names and generally not feeling as sharp or ‘on it’ as they normally are.


Other brain related symptoms can be mood swings, apathy, anxiety and depression which are of course, multi-factorial but can appear or worsen whilst in perimenopause and menopause.


So what's happening?

Changes to the brain begin in our 40’s with cerebral hypometabolism or ‘low brain energy’. Our brains use of glucose as a fuel begins to falter and with that changes to our brain chemistry happen. This is especially true for women as shown in this PET scan.

PET scan of woman's brain premenopause, perimenopause and menupause
Source: Mosconi L et al. PLoS One. 2017 Oct 10;12(10); Mosconi L et al. PloS One 2018 Dec 12;13(12):e020788

The scan to the left shows brain activity in a premenopausal woman; the scan to the right shows brain activity in a postmenopausal woman. Brighter colors indicate more brain activity. The scan to the right (menopause) looks 'greener' and overall darker, which means that the woman's brain has more than 30 percent less brain activity than the one to the left (no signs of menopause).


Many women find body identical HRT works really well for forgetfulness and other menopausal symptoms. However if you’re not at the stage where HRT is recommended or would like to focus on a non-medical approach to managing your symptoms there are nutritional and lifestyle factors you can incorporate into your life to support your brain during this time.


Tea for starters! Particularly green tea and matcha

Cup of green tea being poured from teapot
Amino acids in green tea help to decrease stress and improve cognitive performance

Green tea is a great mood-and-brain food.


Previous research has demonstrated that three constituents present in green tea, l-theanine, epigallocatechin gallate (EGCG), and caffeine, affect mood and cognitive performance.


L-theanine has been shown to decrease anxiety and improve response to stress.


EGCG and l-theanine are also available in supplement form.


Matcha is especially interesting. This is the ground powder of the green tea leaves. The leaves are grown in a way that enables higher production of l-theanine in this type of tea.


We know also that green tea is hugely anti-inflammatory which is good news not only for the brain but for our health in general. It’s well known now that many major health conditions such as heart disease, diabetes and stroke have chronic inflammation at the root.


So how much do you need to drink?

About a tablespoon of matcha powder daily or 3 or 4 cups of green tea is optimum to support brain function. The l-theanine content of green tea stimulates the release of the neurotransmitter GABA which brings about a relaxed, calm state.


Not everyone is a fan of green tea, for some it can be an acquired taste. If you’re a Lyons Tea or a Barry’s tea drinker, all is certainly not lost. Although black tea doesn’t have as much of the powerful catechin EGCG (which has some very promising data in helping with diabetes and obesity) black tea does have brain health benefits, so enjoy your regular cuppa with the knowledge you are still helping to support your brain health (leave out the sugar and/or the biscuits with the tea though ☺).


Choline rich foods

Poached eggs on bed of green leaves with nuts and seeds
Egg yolks contain choline which is an essential nutriet for concentration and learning

Choline is such an important nutrient for our brain that a deficiency can have a profound effect on our long and short-term memory.


You will find choline in eggs (don’t omit the yolk as this is where much of the micronutrients are found), fish, meat especially organ meats such as liver, poultry and also some veg including broccoli and cauliflower.


Another way of bumping up your choline intake is to sprinkle some lecithin granules onto yogurts, oats or into smoothies. You can pick these up in a health shop or some supermarkets. Lecithin can also help to lower cholesterol levels.


Chocolate and other high antioxidant foods

Good news for chocolate lovers, well I should say, for dark chocolate lovers. Milk chocolate doesn’t have the same effect unfortunately.


The brain is very susceptible to oxidative stress, which contributes to age-related cognitive decline. Foods with high levels of antioxidants fight the free radicals that cause this damage. Studies have shown that cacao flavonoids encourage neuron and blood vessel growth in the parts of the brain related to memory and learning. A study in 2018 looked at what happened when people ate dark chocolate (over 70% cacao) and concluded that it helped brain plasticity, which is crucial for learning.


I always recommend that my clients opt for 85% cacao for a greater dose of antioxidants and less sugar. There are a number of great brands to choose from including Green & Blacks, Lindt or the Moser Roth brand from Aldi.


Other sources of antioxidants are berries, especially the darker blackberries and blueberries, herbs particularly turmeric and cinnamon and even good quality coffee which has been linked to the prevention of cognitive decline.


Omega 3 rich foods

Omega-3 fats help build membranes around every cell in the body, including brain cells. They support the development of healthy neurons and neurotransmitters in the brain. A few years ago, a study found that people with high levels of omega-3s had increased blood flow in the brain.


Open can of tinned salmon
Oily fish such as salmon, sardines and mackerel are packed full of essential Omega 3;s

The body can’t produce Omega 3’s so it’s essential we get these from our foods. The best sources include oily fish like mackerel, trout, sardines and salmon. You will also find Omega 3’s in avocados, flaxseed oil, nuts and seeds but to a lesser extent.


Tinned versions of oily fish are great to have in your kitchen, ideally the wild variety as they are better. These can be added to salads, used to make fish cakes or pate, or piled onto a baked potato.


Flaxseed oil along with fresh lemon juice (and or zest) or vinegar such as apple cider or white wine vinegar makes a lovely salad dressing with the option to add crushed garlic or herbs.


Lifestyle Factors

Quit the cigarettes

A research review carried out by National Library of Medicine in 2015 looked at 37 studies comparing smokers and non-smokers. They found that smokers were 30 percent more likely to develop dementia than the non-smokers. The review also found that quitting smoking decreases the risk of dementia to that of a non-smoker.


Cigarettes introduce many toxic chemicals into the body and brain such as cadmium, arsenic and formaldehyde. Smokers have a thinner cerebral cortex than non-smokers which isn’t good news for your grey matter. The cerebral cortex is a part of the brain that is crucial for thinking skills including memory and learning, so thicker is better.


Sleep

Aim for 8 hours of good quality sleep a night. Research shows that sleep may be more crucial for brain function than it is for body function. It is during the phase of REM (or dreaming) sleep that memories are stored and learning is consolidated. Poor sleep causes problems with both of these functions and sleep deficit may play a role in the progression of Alzheimer’s disease and ADHD. We all know the impact of poor sleep on our mood and food choices the next day.


Stress

Chronic stress may result in changes to neuronal (i.e. nerve) structure and function and may also result in neuronal death and acceleration of brain degeneration. It also suppresses neurogenesis (the formation of new neurons) and reduces the expression of Brain Derived Neurotrophic Factor (BDNF) which is sometimes called ‘miracle-gro’ for the brain (my brain could certainly do with some miracle-gro this week!)


Long term stress also affects levels of progesterone and oestrogen. Not good news for perimenopausal and menopausal women whose levels of these hormones are already in decline. The importance of oestrogen and progesterone for all areas of health is not to be underestimated (I cover this topic in more detail on a previous blog post).


Improve your ability to cope with stress, by either removing the stressor or finding some way to better manage it. You can read more about lifestyle, dietary and supplement recommendations for managing stress here.


Conclusion

As mentioned above, the changes to our brain that occur during the menopausal transition are for the most part temporary. Researchers generally agree that post menopause memory very often improves. This time in a woman’s life however, is a critical window for health and a time when small problems (if unaddressed) can turn into larger ones down the line.


Whether you’re experiencing a noticeable increase in forgetfulness and mood swings, or feel it’s just a passing occurrence, it’s certainly the time to focus on your nutritional health and the various lifestyle factors that have been shown to help with symptoms of menopausal cognitive decline.

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