Discovering the Link Between Menopause and Alzheimer’s with Dr. Lisa Mosconi

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Hot flashes, night sweats, depression, insomnia, brain fog, memory changes, cognitive slippage. These symptoms don't start in your ovaries, they start in your brain. These are neurological symptoms. We're just not used to thinking of them as such.

Here's JJ Virgin triple board certified nutrition and fitness expert and four time New York Times best selling author. It's time to reignite wellness.

All right, I just wrapped this interview and I think I might have fallen in love with my guest. Have a good big girl crush on her because she is just so fabulous, so brilliant and has such great information. So I'm super excited to share this interview with you today. And it is about the woman's brain. And what we're going to dive into today is really talking about a women's brain, how it's different than a man's brain. Duh. But why this is so important, how menopause can impact it, what you can be doing right now to make some differences no matter what age you are and what's going on, what, what the risks are with Alzheimer's, et cetera. I mean, just amazing, amazing information. And I am interviewing Dr. Lisa Moscone and she is phenomenal. She is the director of the Women's Brain initiative at Weill Cornell Medical Center. And tell you a little bit more about our associate professor of neuroscience, neurology and radiology as well. And she is also the associate director of the Alzheimer's Prevention Clinic. She's the author of Brain Food and she has her new book coming out depending on when you're listening to this March 2020 called the XX Brain. And honestly, as soon as we were done with this, this recording, I was like, all right, and you're coming back. So she's so good. I'm really excited to share you her with you through my buddy Dr. Anna Kabea and who is just phenomenal too. She wrote the Hormone Fix the Keto Green Way. So you know, great people hang together. And speaking of great people, I want to do a Shout out to K. Christina, 30, from Canada, and she said, thank you so much for creating this safe and informative platform. I only found out about JJ a year ago. I but I feel that I've learned so far change my lifestyle and health. If I may submit a request to invite a specialist to speak about hair loss, which seems to be very common and unrelated to postpartum. Thanks again to JJ and her team for all you do. Yes, we will find someone. Team, you heard that. Let's find someone on hair loss. I actually have a couple people we can talk to about that. And we're going to bring Dr. Lisa back on to talk about hormones because that can help with that, too. Alrighty. I am excited to share this. This interview with you. And first, I want to share this other cool thing with you. Here we go.

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Your education should be a right, not a competition. At University of Phoenix, you'll get the best scholarship or savings you qualify for. Simple as that. Explore scholarship options at University of Phoenix. All right, Dr. Lisa Moscone, welcome to the show. Super excited to have you here.

Thank you so much. I'm so excited to be here.

All right, well, first you've got to explain to everybody listening where your fabulous accent Is from.

Thank you. I was born and raised in Florence in Italy, and I went to school in France. So my accent is. I think it's somewhere in between Italian and French.

And you're just like probably cited everybody's dream, like to imagine growing up in Florence and then going to school in France.

In Paris. I should have said, of course in Paris.

Let's just ice the cake there now. Yeah, you definitely were. You're a neuroscientist. How did you get into this? And you've been focusing on the women's brain. Like what. What got you to here?

I always wanted to study brains ever since I was a little girl. And I think it's because my parents are both nuclear physicists. Like, both of them.

Okay, so you grew up in Florence, Paris, your parents are nuclear physicists. And you are a unicorn. And you're absolutely stunning. Gorgeous too. So you gotta have it all. Okay, so you always. Since you were a little girl. Because most little girls, that's their dream to study brains. I would think.

Yeah, I know that it was a little know. I was very quiet about it. I wouldn't broadcast it. But yes, it was always really fascinated in biology. Ever since I was little, my. My parents would talk to me about my mom studies like protons and. And nutrients and things. And I'm. Back then she was teaching nuclear physics to students would then transition to medicine and they went to work in nuclear medicine, which is that branch of radiology that uses radioactive isotopes to look at brain fun function and brain biochemistry and all these super fascinating things to me as a child. And then they would babysit me when my parents were busy. And so I really grew up thinking and talking about brains the entire time. And so as soon as I was 18, we end. We finish high school, graduate from high school at 18. And so I call them up and they say, I want to train with you. I'm going to start college in like two weeks. And I was doing neuroscience. Right away they said, I really want to volunteer. Can I do that? And they said, sure. And they never stopped. And it was at that time that my grandmother started showing signs of cognitive deterioration. And it was quite subtle at first, and then it got progressively worse. And because I'm Italian, so your grandparents live pretty much next door from you. And it was so evident that she just could not function. And then a few years later, she was diagnosed with Alzheimer's disease. And that's exactly when I was going to college. And I was like, okay, this is scary. And then her two sisters Also developed dementia a few years later, whereas their brother did not. So there was quite a red flag. And I remember my mom being really worried. And my grandmother's sister's children were also like, okay, what do we do? How do we deal with that? But also, are we at risk? And that's a question that really nobody was addressing back then, like, 20 years ago. What do you do if you're at risk? What do you do if you have a family history of Alzheimer's or dementia? Is there anything that you can do to avoid it, to prevent it? Is it entirely genetic and you're doomed? Or. Or is there something you can do about that? And so immediately, I started studying Alzheimer's disease, and it's been 20 years study.

Wow. And you've really focused on women's brains.

Yes, ever since. Ever since I was 19 when I said, I want to look at women's brains. And there was so.

We know it intuitively, too. Lisa, when you think about it, like, it's obvious that we're different from men.

Yes, it's so obvious, but nobody believes it.

But how different are, like, I mean, you know, I've. I've looked at this a lot from kind of relationship perspective of how differently women think than men, and a lot of that just being kind of so tribal. But, like, in terms of just our brain's function structure, how different are they from men?

It's really. It's a very good question. And there are. There are different ways to answer the question. And I would say the most accurate way is to. To say that there are differences that are very clearly biologically and chemical, you know, from a chemical perspective. But there are no clear differences from an anatomical point of view. Like, it's not like women have different brain parts than men don't have structurally, we kind of have the same brains. But then it looks like women's brains are better interconnected than men's brains. We have more functional connectivity. We have more the brain parts like the hippocampus, which is the memory center, the amygdala, which is the emotional center, they're better connected to the rest of the brain as compared to the same structures in a man's brain. And what we have shown just recently is that men's brains and women's brains age differently. And I think that's perhaps the biggest difference that I have come across, that women's brains just do not age the same way the men's brains age. And this is not in terms of being 70 or 80. I mean, throughout the Entire lifespan for us. There's a very strong hormonal component to really, you know, you hit puberty, and there's an explosion of neuronal power and strength. But then women go through menopause, whereas men do not. And menopause is a big. Is a real big deal for a woman's brain.

So let's. You just. You just. I'm, like, scribbling over questions and notes over here because you're just dropping all this stuff. I'm like, oh, my gosh. Okay, we start. Let's start first with. You said that women's brains are more interconnected. What would be good about that? What does that. What does that mean that makes us different than men having those interconnections?

I think there are different explanations and interpretations. I think what is. What seems clear is that from an evolutionary perspective perspective, women always had to take care of the children and the family. Even when our ancestors were just born, so to speak, the men would go off hunting and the women would stay behind and tend to the children and the elderly and each other. So it looks like those parts of the brain that are very closely involved with having a family and having an instinct towards taking care of others developed very, very strongly in women. And so those parts of our brains are better related. They're better connected to the other parts of the brain, which is possibly why women have such strong caregiving things. Right. So that's one explanation that I personally think makes sense.

Yeah, makes a ton of sense. I was writing down. I mean, women, what I see is we build communities more.

We are more caretaking, we're more nurturing.

So then you talked about us aging differently, and I would love to, like, talk a little bit about menopause, because I think any woman who started to have, you know, go into menopause and feels her estrogen drops knows instinctively that something like as they walk, as they walk back into a room and go, why did I go to this room? Like, oh, my gosh, you know, talk about what happens during that time and what. What the. Of, say, having estrogen drop and. And then the other side of that is, don't men go through something similar with testosterone that would have a similar type of. Of effect or.

No, it doesn't. So men do go through andropause. So it's the male equivalent of menopause, but it's a very slow and gradual change that takes many, many years. Usually men go through full andropause when they're like, 70 or older than that. Just think about Mick Jagger, I think he just turned. He just had another child, like his eighth kid, and he's 8 years old. It is very common for men to not experience this reproductive infertility until very late in life. And also, if you think about it, testosterone can be converted into estrogens, so they never suffer the declines in estrogen levels that women suffer during menopause. So basically, men's brains are fine hormonally. And this is really where the research showed. I've been looking into that for a long time, and I do brain scans all the time. I do. Brain imaging really is my specialty. And we have looked. My colleagues and I have been looking at thousands and thousands of brain scans of men and women of all ages, from 21 all the way to 90 and older. And we've been trying to see if men and women progressed the same way. They changed differently, there was anything that would really stand out. And what we learned is that there's a huge difference between men and women and between men's brains and women's brains. In midlife, when women go through menopause, and I'm a brain scientist, I never thought that I'd be talking about menopause or hormones. We just don't think about the connections between our ovaries and their brains. But there's such a strong connection for women. So when you're thinking hot flashes, night sweats, depression, insomnia, brain fog, memory changes, cognitive slippage, these symptoms don't start in your ovaries, they start in your brain. These are neurological symptoms. We're just not used to thinking of them as such.

Well, are they neurological symptoms because of a lowering of estrogen that's creating the problem? Because I think back to, you know, okay, you don't think about. You never thought you'd talk about menopause as a brain scientist, but just think about PMS symptoms. I mean, you know, it's clear that our hormones are. Are impacting our brain function. Absolutely right. So does this mean then, like, because we seem to be. We seem to have more fluctuation hormones, obviously. I always say that men are like a VW bug car. And we were like, you know, Ferrari. We've got a lot more. We've got a lot more wiring and a lot more things that go on and a lot more hormonal cycling. Does that put us at more risk for things like depression or mood disorders or any of those types of things?

Yes, yes, that's exactly what's happening. I think something that usually is not discussed is how our sex Hormones in quotes are not necessarily only related to reproduction. They're also really strongly involved with brain function. So, for example, there's estrogen. Estrogen is a master regulator in the female brain. It serves a number of functions that have nothing to do with having kids and have everything to do with having energy. Estrogen literally activates your neurons and is involved in neuronal growth, in plasticity, and also in immunity in the immune system. So the more estrogens you have, the more sex hormones you have, the stronger your brain is. And that's the reason why, when your sex hormones begin to fluctuate and eventually you lose your estradiol and you have all these other changes, your brain needs time to readjust. And this readjustment sometimes doesn't go too well, like when you get the hot flashes and night sweats and insomnia. And sometimes we found that actually leads to more serious problems. And we have found that for women, menopause could be really a trigger for Alzheimer's disease.

Wow. So if that's the case, as I'm listening to this, I'm thinking if lowering estrogen from menopause is a trigger for, you know, Alzheimer's being the extreme. But even, you know, Right. Hey, serious depression.

Yes.

And then we're looking at treating with, say, an Alzheimer's medication or an antidepressant. Wouldn't really the treatment be bioidentical hormone replacement?

It's a very good question.

Did I just. Did I just, like, step on a landmine here with you?

No, not at all. Not with me. It's more with the scientific community. There's a lot of debate over this right now. And there are different school. There are different schools of thought. You know, as with everything else, I think it depends. So if you have an Alzheimer's predisposition and the predisposition is activated by menopause, for me, I would want to really treat both.

So how would we know so someone would have an Alzheimer's predisposition because they're doing genetic testing, like the APOE testing or what?

There are many different risk factors for Alzheimer's, and some are genetically based, but many are not. So there are some genetic mutations that cause Alzheimer's disease, and those are a whole different story. And then we have some genetic risk factors by the APOE gene that you mentioned that increase risk but do not cause Alzheimer's disease. And then we have another number of genetic risk factors like APOE that nobody talks about for reasons unclear to me, but there are another 20, 30 that also increase risk of Alzheimer's disease mostly by increasing inflammation, which I think is something probably interesting to you because lifestyle can really help reduce the risk.

Yeah. You know what I love Lisa, is every time you go, start to look at genetic predispositions or anything and you come back and go, oh, what things help there? It's like, oh, diet, managing stress, sleeping well, lifestyle, exercise, you're like, like oh, go figure. You know, it just gives you more and more rationale for the things that we should all be doing, which is super cool. So genetic predispositions, but again, it's like loading the gun, not pulling the trigger. And then what are some of the like things that could set you up? Environmental, I would assume, types of things.

Right. So we have medical risk factors. We have a number of medical conditions that really seem to to impact the brain and accelerate Alzheimer's disease onset and progression. And these are heart dise is a really big one. Hypertension, high cholesterol, diabetes, obesity, depression. You know, midlife depression has been shown to increase risk of Alzheimer's for both men and women, but much more so for women than men and the same for thyroid disease and diabetes. So anything that is kind of metabolically related seems to activate Alzheimer's more in women than men. And this is something that is just coming up right now. Literally. I think it's just been a year that more and more people are aware that men and women probably have different routes towards Alzheimer's. For men is more vascular related and for women is more about metabolism. Which brings us to lifestyle and environment. There are so many risk factors you mentioned like stress, diet, exercise, lack of sleep, lack of intellectual stimulation, lack of social engagement. All of these affect women brains more than men. Also smoking and environmental toxins, they all seem to affect women more than men and specifically women's cognitive health. Smoking is really the number one cause of early menopause in women.

I just, I just, I'm always shocked to hear that anyone still smokes. It's like. So I am hoping that everybody listening has that. That's just not something they do because I mean it's not, you know, it's not 50 years ago when we have the research on that one. But some of these other things. Why don't we dig into some food stuff since I always like to go there. What are things, Some of the foods that would be big no no's for your brain health.

Processed food. So in terms of nutrients, trans saturated fats or trans unsaturated fats or trans fats for short are probably the Worst type of fat that one can eat. And they're particularly bad news for women. They've been associated with over 30% higher risk of heart disease and twice the risk of dementia in women, especially those younger than 65. And processed food is everywhere. Everywhere. Like I mentioned, I'm Italian. I love French food as well. And I'm having a hard time. I used to have a hard time when I moved to the States because so much of the food is processed. And there's this huge study that's been following over 100,000 women and men for like 18 years. And they found that those who consumed processed foods consistently had a 12% increase in all kinds of cancer and over higher than that, like 15% increase in breast cancer in postmenopausal women. So I think processed food should be the biggest. No.

Yes. Because of the damaged fats, the chemicals, the artificial sweeteners and fructose and all of these nasty things that we need to avoid. And what about some of your favorite.

Foods that help with brain health for women specifically? Right.

Yes. You did write Brain food.

Yes, I wrote Brain Food. And Brain food is really for men and women. And I have this new book coming out in March that is called the XX Brain and is specifically about women's brains. And I also talk about a diet that is specifically good for women's brains. And the thing they. The three key nutrients for women's brains are antioxidants, polyunsaturated fatty acids, and phytoestrogens. I think everyone is familiar with antioxidants.

So let's talk about some of the top foods that you like to get antioxidants from.

Berries.

Okay.

For sure. So it's been shown a few times that eating at least three servings of berries a week keep women's brains younger by two to three years.

Excellent.

Well, we have a bunch of smoothie restaurants, the recipes with berries in them. So we're good there. We've got that one. And your favorite, polyunsaturated fats, which is awesome.

Yes. What's yours?

Yes. Wild salmon. I mean, I had a son who had a traumatic brain injury, nearly died when he was 16, was hit by a car and in a coma and literally left for dead. Diffuse axonal injury. And we had to start after four and a half months when he came out of a coma after a couple weeks, but he came out of a coma after months, really? And we had to start all over again teaching him. But one of the things that I did, and unfortunately I had to do it behind the first hospital's backs because they would not approve. It was high dose fish oil. Especially after I ran into Dr. Sanjay Gupta in a green room and he told me that he was like, you know, bringing blue babies up from the bottom of pool floors, you know, and getting them back to normal. So I was. So we did a lot of. We did 20 grams of fish oil with him for months and then down to 10 and now he stays at 5. And he was on 5 grams before. So I'm a big advocate of fish oil because of it. Protecting your brain too. And then I have, I have wild salmon.

Nice.

At least three times a week. So I rotate in. I actually don't. I'm careful with tuna because the heavy metals. But I get this one kind of tuna from Vital Choice called Ventrusca, which. Have you tried this?

Yeah, it's the best thing.

You say it way better than I say it. Okay. So. But it's, it's these little tiny cans. It is loaded with dhea. It's so incredible. So I do that. I'll do that tuna. And then I just told my husband we need to go get some wild halibut. So we get all our stuff shipped in from Vital Choice. So we're big, we're big fish people over here.

Have you tried fish eggs?

I, you know, fish eggs and, and sardines are kind of in the same scary category for me that I like to. I'd like to say yes. And I just talked to a guy who is supposed to send me. Now that you say this. He's. He's starting this kind of like dry farm wine does for wines. He's doing that for caviar. And they actually have their own fish egg farms. And the whole bit I'm like, wow. But he's sending it to me. It's, it's. I still find it a little scary. It's so not a.

It's his name. Sony.

Yes.

Oh, no. Yeah, he's fantastic. And they have fantastic caviar.

Awesome. Yeah, I just realized he's supposed to have sent it to me and he didn't. So I'm going to follow up with him. So anyway, that's my intent is to try that. And then for phytoestrogens, I'd like to dive into that a little bit because, you know, are you putting soy in that? Are you getting that more from flax? Where are you getting your phytoestrogens from?

Well, personally, yes, from lignans. I try to go more flaxseeds, sesame seeds, Chickpeas. For some reason my daughter loves chickpeas, so we always say homo.

I did not know chickpeas had phytoestrogens in them. Wow.

Legumes.

That's fabulous.

Lentils are really good sources.

Lentils are amazing food. That's good because I'm, you know what I've seen on the soy research is not positive for brain, especially for men. So I don't know if that's men related on it. You know, basically shrinking. Shrinking their brain and having early dementia. And I'm totally paraphrasing it, but so I like that it's more flax. And I also see people a lot of food intolerance and soy so processed and needs. Yeah, I think the problem is gmo, blah, blah. But flax I'm a big fan of. It's easy to throw into your smoothies, so that's a good one.

Dried apricots.

Really?

Yes, they're one of the best source. Very high content of isoflavones, peaches, like nectarines, white peach, strawberries. Yeah. And I don't know how you feel about grains, but grains are also good sources like whole grains.

It just depends how they're prepared. And if someone has an issue with gluten and making sure they're GMO free and all that kind of stuff. And if they don't have glyphosates, which then would have a whole other problem, you know.

But let's say rice. How about rice?

Yes. I'm a big fan of wild rice.

Right, Perfect. So that's a good source.

Awesome. Awesome. We will see. I'm going to see if we can grab some of this and put together a little list. But I love, I love the fact, you know, it makes it very simple just to think in terms of antioxidants and good healthy omega 3 fats and phytoestrogens is just making sure that you're including those in your diet, you know, like at least multiple times a week, if not so many things. It's easy enough to do every day. But if we said, hey, fish three to four times a week and berries three to four times a week and you know, getting in some kind of little phytoestrogen every day, which is pretty simple. That's like, I mean probably most people are already doing that, but it's easy enough to incorporate, which I always love.

Love doing and you know how. So eating fish regularly like once or twice. Once or twice a week has been associated with a later onset of menopause. So smoking puts in early menopause, whereas fish delays it.

Ah, well, one thing that can really menopause is having your son nearly die when you're 49. I was like, and you know everything and I hit the skit. So that was not that. But he made it through and he's better than ever. So, you know, and my caretaking instincts were, were right on. So there you go.

Yes, absolutely.

Now we are going to include in the show notes and what I will do is I'm going to put these all@jjvirgin.com xxbrain so I'll put everything there and we're going to include links to your brain food book. We'll make a little fun handout of some of the different things that you talked about here so that people can incorporate this into their daily diet and into your next book that's coming out in March. Not sure when this is coming out, but this is great information. And again, I had a great mentor early on in nutrition who was talking about Alzheimer's and he goes, it's really, I know it's hard to sell prevention but he always said, hey, it's hard. You can't unscramble an egg. So very important, Right? I mean, it's like it's right. That is the time to worry about your brain is not when all of a sudden you're can't think about anymore. I think that's one of the biggest challenges with Alzheimer's treatment is, you know, people start way too late and then they can't even remember to do the treatments or anything else. So time is now. And as you can see, a lot of this stuff is stuff we've been talking about already. It's just now we know that it also has a big impact here because we didn't even talk about stress, sleep and exercise. We could do a whole other show on that. So anyway, thank you so much for everything. I super appreciate your time today.

Thank you for your opportunity.

Hope to meet you one day in New York.

Oh yes, that would be wonderful.

Yes. All right now after the break, I'm going to be sharing my top takeaways and what you can do to put this into immediate action. So stay with me.

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Alrighty. Welcome back. So this is when I share action steps, top takeaways, what you can do from today's information to put it into immediate action so that we'll start to improve and up level your health. And I just loved how Lisa said those three things about diet because I went, well, there they are right there is that your diet should have phytonutrients, it should have antioxidants and it should have phytoestrogens. And so again, we're going to give you a handout in this podcast and you can go to jjvirgin.com xxbrain and we'll put my favorites in of each of those. And the commitment is to get in. I'd love to see some antioxidant rich foods every single day. She said berries three to four times a week. But we have an opportunity every day in our smoothie to throw something rich in there. And of course you're getting in antioxidants throughout the day in your deep green leafies and your other plant based foods. So. And also by the way, you get a two for one if you do antioxidants and you do wild salmon because it's got astaxanthin and it's a great antioxidant. So we'll put in my favorite antioxidant rich foods, one of my favorite polyunsaturated fats, and we'll put in my favorite of the phytoestrogens. And the goal is three to four times a week, which with each of them. But I think really when you start to look at these foods, like getting phytoestrogens from different legumes and from freshly ground flaxseed meal, well, that's easy enough to have something there every day. And then of course the berries and then getting in some healthy fats every day, especially things like wild salmon, wild halibut as easy ones. And then we'll look at some of the other things that you can do as well. Okay, so that's my challenge to you. I'm issuing it, I'm doing a throwdown to start to make sure that you have these in your diet. And my guess is that if you've been around this, the community, you probably already incorporating them in, especially if you're doing a smoothie. We can get a lot of this stuff in your smoothie every day, right? Not the salmon, that would be icky and weird. But the rest of it we can do. All right, see you next time. Oh, and by the way, if you haven't done it yet. I would love to shout you out at the beginning of the show. So leave a review. And while you're there, be sure that you subscribe so you never miss any of this. Goodness. You do that up by going to subscribe to JJ.com because we have a bunch of cool stuff now. We're doing interviews every week, we're doing solo episodes every week, and then we got Friday Q and A. So subscribe so we can let you know when a new episode drops. All right, see ya.

Hello listeners. This is Anne Bogle, author, blogger and creator of the podcast what Should I Read next? Since 2016, I've been helping readers bring more joy and delight into their reading lives. Every week I tag all things books and Reading with a guest and guide them in discovering their next read. They share three books they love, one book they don't, and what they've been reading lately, and I recommend three titles they may enjoy reading next. Guests have said our conversations are like therapy, troubleshooting issues that have plagued their reading lives for years, and possibly the rest of their lives as well. And of course, recommending books that meet the moment. Whether they are looking for deep introspection to spur or encourage a life change or a frothy page turner to help them escape the stresses of work, school, everything, you'll learn something about yourself as a reader and you'll definitely walk away confident to choose your next read, with a whole list of new books and authors to try. So join us each Tuesday for what Should I Read Next? Subscribe now wherever you're listening to this podcast and Visit our website whatshouldireadnextpodcast.com to find out more.