Lifestyle or something else. The problem is that gender gap. The most overlooked, underdiagnosed research field. The first one, they were excluded from research. A number of reasons, there was no research in it. All of this medical research, it is biased against womens brains occurring to bikini magazine. What makes a woman a woman, part of the body under the bikini. It is about ovary or hormones. About womens health, we never talk about womens brains. Being misdiagnosed. You talked about your connection to alzheimers. Your mother in law was diagnosed with early onset alzheimers, where we can be doing better in our lives. Lets go back to the question or hormones, what does estrogen have to do with alzheimers. The thing is brains do not work in isolation, connected with the rest of the body. In their reproductive system and a key to brain aging. It is communication between the brain and the reproductive system, hormones different between the genders, what people dont realize is hormones in the body, they just have different functions in the brain. We think of these as being involved in reproduction but in the brain they serve a completely different function related to heavy energy. It pushes neurons to burn sugar to make energy. If estrogen is high your brain energy is high. It is superpowered in the brain, keeps the Brain Healthy and young. The thing, it fades gradually over time, but women lose their superpowers of estrogen but live another 30 years. In a positive stage, the estrogen provides. How does that affect the brain as you start going through menopause and start experiencing the loss of estrogen . We can see on the brains can as the neurons slowdown it makes less energy. That is associated with accelerated aging process. After menopause your skin, not all women obviously but many women, their skin is drier, their hair more fragile. It is not a huge severe problem, the brain is also starting to age. We can see that, for some women the changes are very very mild, we have studied hundreds of women at this point and we find a difference in Energy Levels in the brain, does not correlate with reduced cognitive performance was women perform just as well as men the same age. Womens brains are compensating and we are trying to find out how because the energy and estrogen, they are performing really well. So that we can promote and support the compensatory mechanism. A couple chapters in the book, all section particularly that focuses on hormone replacement therapy and who should think about it, shouldnt. I recommend people read that because theres a lot of different areas you go through and say you should or shouldnt. Cancer or Breast Cancer survivors, you have to purchase differently but for those approaching menopause or already there already, what do we need to be asking ourselves when it comes to hrt . Why do you need and why do you want it . There are Different Things that can be achieved safely. Your strength, something to discuss with your doctors, some women it is just not manageable, or other women, the best dosage really depends on what youre trying to achieve, the symptoms you are trying to alleviate and number one i would like therapy of prevention. Has been done in some ways but not in the best possible way. We need to start younger before menopause and that hasnt been done yet. That is an unexplored area of research and there are many questions that need to be answered but also really interested in what we can do instead of hormone therapy because there are many natural behaviors, strategies that can be used that pretty much have the same results with many women. We will get into the lifestyle prevention exercise sleep, all of that plays a part. Let me ask you first what about genetics, what is the genetic connection and link . My mother in law with early onset alzheimers. My husband and i are very much about health and wellness because we know perhaps theres a risk for him . I recommend testing and i have a chapter in the book about how to approach testing which starts with very detailed Family History questionnaire because years earlyonset alzheimers, didnt happen to other family members. Multiple family members affected because if so it is genetic. If its an isolated case it doesnt but a number of things that clinically we would like to find out for the assessment. Disease comes in two major firms, earlyonset, genetically determined that is caused by genetic mutation and that is an aggressive form. I am hoping it is a mutation but most likely eligible. 1998, 99 do not carry the genetic mutation and for the majority of those cases it is genetic risk factors rather than mutation but those are medical history, lifestyle and environment that altogether modulates. Let me ask you about that because there are medical risk factors that could also affect your risks of developing alzheimers. Heart disease, thyroid disease, metabolic disorders, traumatic brain injury, can you talk a little bit about that . There are many different medical conditions that do not necessarily affect the brain, but they could trigger, could promote the disease and these include the ones you just mentioned, and mixed body disorders are important because they have another component but what i think is really important is many different risk factors, over 30 and we are just learning how these risk factors affect the chambers differently and it really looks like men and women almost of two separate pathways whereas for women they are more inflammatory so there are some risk factors that increase more in women than in men than the other way around. It is funny in a way that many risk factors affects women more than men but only women but not men but the number one risk factor in men is not being married. Why is that . There are so many possibilities. The number one factor for men is not being married to a woman. I dont think being married to a woman is healthy, because it started when data was collected many years ago, same sex marriage which is not allowed in this country, the point is women are really good at taking care of people. We are in charge of the health of the entire family, catch the medical appointments, make sure the husband is taking the pills. I thought that was cute when i read it. Which is a perfect segue to lifestyle and prevention. We have some viewer questions, somebody asking what is the single most important thing a woman can do for her postmenopausal brain . The single most important thing i believe is to really look at your lifestyle and find part of your lifestyle that is not where it should be where you would like it to be because everybody has different risks and a different baseline. For me there would be stress reduction because i am not good at that. Very hard. A lot of women it is maybe diet. Youre just not eating healthy. There are eight key affects in a happy female brain after menopause and they include mental stimulation, intellectual activity especially when learning, learning you to your brain what exercise is to your muscles. It can really stimulate connections between different regions and that really keeps the brain plastic which means young, learning, you need to challenge your self. If you like to read books dont read a novel, read something that is really challenging. If you like to watch movies watch a documentary so you learn something. You need to feel engaged. My mom plays four times a week, and keeping her brain young. Besides that, i know that diet has to be in that eight steps. How important is moderating what you eat but also what kind of food you should be eating, you also wrote the brain bokum. Reasons. Things we eat have an effect not just on bodies but also the brain, the brains are made of nutrients so we need to replenish nutrients on a daily basis especially for women, i recommend antioxidants. We found a strong correlation between the intake of antioxidants and the diet of a, c, and d throughout the life spine, the more nutrients you consume on a daily basis the higher your brain energy over time. We eat three times a day, Three Chances every day to make a choice from brain health so the brain gets to form so much better for us. I am a strong proponent of a healthy diet, for my brain as much as my can and much of the Research Even my parents are italian. The mediterranean diet which you write about in the book, the diet most people should follow. It is a good template, very fresh diet reached in the nutrients that the brain warrants and needs. It is not a deprivation diet. I cant be deprived. I like to enjoy my food. What i like about it, it didnt come out when somebody was thinking about it. It is the result of thousands of years of agreement about doing significantly better. It doesnt have to be an experiment. It is more the framework. Vegetable oil, and a lot of fiber, really good for you and we dont talk that much about the issue. There is a huge hundreds of thousands of women showing what you eat, immunological to menopause. I think it is really interesting. Complex carbohydrates, they show the more refined sugar in your diet the earlier in life you have menopause even if there is no genetic piece to it. Not just something we do for fun or pleasure but food is function. Something we can actively do. There is an important factor. Slow and steady wins the race. The moderate exercise is the root to go rather than people taking all these we were going to jims and can take highintensity classes. Now we are doing the videos at home but why is slow and steady a pace for exercise and how much exercise should we be getting . It moderates energy. They are starting to look into that. They show an inverted u shape, you have low intensity you have no gain, you reach the hit. If you go towards higher intensity your gains are increasing. That is for women age 40 and older. As long as the anesthesiologists really support it you can do any exercise, superhelpful. For many women they are all average, a huge group of people, women who are older than 40, especially post menopause is more sustainable. You do it often enough, you can see a bad state. For many people you go high intensity and you are tired and dont do it consistently enough. It is important that if you can it is okay. You dont have to feel bad about it just because it is trendy. Host i was going to ask about sleep. How does poor sleep quality impact women and their brains as they age . That is my issue. National science foundation, women trend worse than men of any age. We have trouble falling asleep, we have trouble staying asleep, the quality and structure of the sleep is discussed as well. That seems to overlap with middleage. Many women, i dont want to say every thing is for mona but diseases for mona impact on sleep, to protect and defend, theres a ticket price for the brain, the brainstem, it is in charge, estrogen activates this week. It started to go up and down to project them and the region is not activated correctly. Then you wake up in the middle of the night and stress is the same because melatonin is really high until 2 00 in the morning and decreases and adrenaline goes up, a lot of stress, you wake up at 3 00 in the morning which happens to a lot of women. I know that a lot of us are doing that. Host do you speak well . Guest i dont. I have been struggling with sleeping well. During the pandemic it has been worse. All of us are feeling stress and anxiety but im perimenopausal and i am up in the middle of the night, i have to get up and go back to sleep is very hard. I have been taking valerian which i wanted to ask for supplements that women, what are the ones you recommend and these are things you should talk about and get something that reacts well with your body. Im a strong believer in texting deciding which supplements to take. A lot of people go for multivitamins. It doesnt really help if you are deficient in more nutrients that are usually included. What we do, we do a lot of black testing to measure the antioxidants and the b vitamins and if there are any deficiencies we supplement but first of all we go through a Diet Examination because the best way to supplement is changing good diet. In some cases the healthy diet is not enough and the supplement we tend to recommend the most especially for women are omega3 fatty acids, do not eat fish. We do not eat fish enough. I am very fond of Flax Seed Oil. For women who dont eat fish very often, Flax Seed Oil has the highest concentration of omega see fatty acids, it is about half of all the omega3s. Im and olive oil kind of person but i switched and i am using that for lunch. Host what about vitamin e, vitamin c . Guest i encourage postmenopausal women to consider taking them. It helps with sleep for a lot of women especially the combination of a cream with vaccines, really alleviates the night sweats. It has been shown to work for many women. There are side affects. Host over a counter per restaurant cream. Guest a possible simulation but vitamin e is a strong antioxidant as well that stimulates blood flow and oxygen levels to the brain. It keeps your energy high. Something to keep in mind. Honestly antioxidants are best obtained for nutrients from the food that we eat so it is possible to consume more orange, yellow, dark, green, leafy vegetables is the best way to supplement. There is all a so much salad one can take. Host theres so much information i encourage everybody to read it. The the xx brain the groundbreaking science empowering women to maximize Cognitive Health and prevent alzheimers disease, to track the progress of the these, is the testing accurate. Before we went live you are saying you your self will have a brain scan which you havent done before. Guest i am a big fan of brain scans on an individual basis. It is a very strong diagnostic tool and a good predictor. We do a lot of brain scans. To really make sure we address concerns and make them comfortable. You dont have to if you dont want to but most of us do want to and we do mri scans, imaging scans and pet scans, Nuclear Medicine that i have been doing for many years. We look at everything we can. We look at the structure of the brain. We try to see if there is any shrinkage of the brain. We look for inflammation in the brain, we look for integrity around different parts of the brain communicating with each other and Energy Levels in the brain, we look at alzheimers, cell pathology, vascular damage for men and women in the brain after menopause. And the Immunology Department and our patients, the youngest is 40 but we lowered the age range and it is helpful to have a good baseline. It is helpful to you for life because now you have no promise. God forbid in ten years there are some concerns. It happens a lot and we know another brain scan, if you come to me when you are having trouble, that is a clear problem as you can see immediately. You have a baseline to compare it to. It is always better to check for change but no change. If there is no change you are having a hard time in different ways. It is a change. It really helps a lot to have as many high points to the brain is possible. Host there is so much information in this information in this xx brain the groundbreaking science empowering women to maximize Cognitive Health and prevent alzheimers disease, doctor lisa mosconi, it is brilliant, i read it cover to cover within a couple hours because i wanted to digest every bit of information so thank you so much and to all who participated here today and be sure to check out lisa mosconis book if you would like more information and you will be seeing if you missed the beginning of this podcast you will be able this webcast, you can see it at a future time, we will put it on the streaming service as well. Thank you very much. Booktv on cspan2 has top nonfiction books and authors every weekend. Today at 1 00 pm eastern from a recent virtual southern festival of books authors sarah march, Thomas Burton and rehwinkle reflect on life in appalachia. Waterboarding david program discussed the jim crow era in the south. At 7 4 05 pm new yorker staff writer discusses his book joe biden, the life, the run and what matters now. On sunday at 1 00 pm eastern from the southern festival of books journalist matthew then you talks about the Delta Justice about a civil rights case which helped to reaffirm the right to trial by jury in most criminal cases and Stephanie Gorton and chris hanby offer their thoughts on Investigative Journalism and its role in a democracy. Then at 9 00 pm eastern on after words law Professor John fabian with talks about his book american contagion, epidemics and the law from smallpox to covid19. Is interviewed by Georgetown University law professor. Watch booktv this weekend on cspan2. Every your booktv asks members of congress about the books they are reading. Host joining us once again on booktv is congressman gerry connolly, democrat from virginia. Give us an update on your reading list, congressman. Guest as you know i read at least a focal week and since we