19 Comments
Jan 20Liked by Annie Fenn, MD

Hi Annie- my fear is around a category of foods…saturated fats. I usually stay away from them but I’m wondering if there’s a daily max you’d suggest? I am trying a meal

delivery subscription which is really supportive to get more veggies and variety in my diet but they have curries, pesto, dressings and sauces that usually have up to 5 grams of saturated fat per serving. Do you have any guidance on this? Thank you!

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Hi Rachel--Great question! It's smart to keep an eye on the amount of saturated fat you consume. General health guidelines recommend keeping it under 10% of calories, but brain healthy diets advise even less, under 7%. If you are trying to get your LDL-C down, sat fat should be under 5%. Each gram of fat gives you 9 calories. In a 2000 calorie/day diet, 7% sat fat is about 15 grams or 140 calories. 5% of total calories is about 11 grams or 100 calories. Meal kits are great, like you said, for many reasons but you may want to mix up a few of your own sauces that have mostly monounsaturated fats with fewer saturated ones. You could take the meal kit pesto, for example, and swirl it into nonfat yogurt with a squeeze of lemon. A good rule of thumb when shopping it so make sure a food product doesn't have more than 1 to 2 g sat fat per serving. I don't generally do the math every day—counting calories and tallying up fat grams —but instead try to follow MIND/Medi guidelines where this is already factored in.

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Jan 22Liked by Annie Fenn, MD

Thanks so much, Annie!

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Oct 24, 2023Liked by Annie Fenn, MD

The fear that restricts me the most is a little different, I guess. My issue is that restaurant food has increasingly given me bad results (often diarrhea) so I have increasingly wanted to avoid it. I structure any travel around bringing food or sourcing food to avoid prepared restaurant food. I don't want the GI issues but mostly don't want to waste time/opportunities for fun on a trip feeling yuck -- so instead I "waste" time dealing with my own food and missing out on opportunities for trying new foods. My gut (ha ha) tells me it has to do with the oils used to prepare the food -- too much and the wrong kinds. So - if I were avoiding one food, that would be it. Moderation in this issue doesn't feel possible - and it is restrictive.

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Hi Amy. I think it's totally normal that you would want to avoid those oils that make you sick. Once you start eating a brain-healthy diet, you no longer have the microbiota community needed to digest that stuff. It does make travel tricky, and I face a similar issue. One workaround I have is to travel with small containers of EVOO for dressing salads and drizzling on food. I have good luck traveling in most European countries, too, where the oils are good quality.

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Oct 23, 2023Liked by Annie Fenn, MD

Thank you so much for addressing the fear of eating certain foods that we sometimes enjoy on a rare occasion.!

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Hi Beth! Yes, like all that gelato we had in Italy:)

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Oct 23, 2023Liked by Annie Fenn, MD

I would like the recipe for the date/peanut butter cookies pictured in your email but could not find it. Help!

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Hi Julia! The source is listed in the caption under the photo. Sorry, but it's not mine to share--it's from the Fiber Fueled cookbook.

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Oct 23, 2023Liked by Annie Fenn, MD

The vast majority of the time, I follow brain health guidelines closely and don't find it difficult. But every once in awhile I get an intense craving...often when I'm stressed...and it's usually either for chips or for candy. Bad stuff! Sometimes I can fight off the craving (or replace it with something healthier) but other times I give in and *always* regret it, not because of fear but because of how it makes me feel physically. Not sure when I'll learn my lesson but I'm sure hoping it's soon. :-)

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Hi Deb! I think that must be a really common thing. Stress and lack of sleep are definitely known confounders of good choices!

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Oct 23, 2023Liked by Annie Fenn, MD

I have struggled with food and restrictive dieting in the past. And though I’d really like to lose some weight now, for my mental health, I know it can’t come from rigid restriction, from counting points as a proxy for calories, or any regimen that is premised on intense scrutiny and documentation. In general, I think I eat quite well, and my diet is definitely « Mediterranean » because that is my cultural background! I limit meat and dairy and eat lots of fruit and veg, and can go days or weeks without alcohol. My biggest struggles have been psychological: in the past, eating to please others, and now, eating out of stress. Chocolate is a favourite for the latter :) I don’t know that I have anything concrete to add about specific foods and Alzheimer’s fears, more that I think it’s worth recalling that there are other controllable factors for AD, including stress, social connection, and ongoing learning. So if I’m not 100% « perfect » about food, and am carrying a few extra pounds, I have to assess what will most benefit me: counting calories/losing weight/being « perfect » with food? Or accepting some of my baggage (physical + psychological) and acting on those other factors that are also neuroprotective? At this stage in my mid-life, I try to allow myself some grace with food, being as « good » as I can without aiming for unrealistic perfection, and instead think about those other aspects of my life I know could be better (stress, in particular).

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Bijuana, you have framed this so beautifully. Thank you! I totally support the concept that food is just one thing we can do to prevent Alzheimer's. There are others! And perhaps the other pillars of prevention are not so emotionally charged for many of us. The food part doesn't have to be perfect, it just needs to be pretty solid. Acceptance of self is healthy and essential. Perfection is absolutley unrealistic. And this: Allow yourself some grace. Brava.

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Oct 22, 2023Liked by Annie Fenn, MD

My favorite indulgence is good quality cheese and dessert. I have made a decision to cut back more than eliminate. Desserts are a little easier to keep out of our home. Like Peggy I try to visualize how harmful it can be.

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I love how you reframe this as cutting back not eliminating. That was the spirit of the MIND diet guidelines. And it makes eating for brain health more enjoyable and doable.

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Oct 22, 2023Liked by Annie Fenn, MD

Thx Annie for opening up this conversation as the more sophisticated I get about brain healthy nutrition the more self critical and anxious I have gotten about eating certain foods. I used to be pretty relaxed and forgiving and now I find myself imagining the mayo type dressing on the otherwise delicious mushroom taco I just ate in Mexico traveling up to my brain and creating unhealthy plaque! I am being dramatic but it has caused me to be more “uptight” about what I eat. I try to forgive the less than optimal meals while traveling or eating out and then try to do as good a job as I can when cooking and eating at home. I looking forward to hearing others’ suggestions and perspectives!

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Well, that mushroom taco sounds amazing:) But I hear you on this: knowing what's best can create anxiety when things veer off-piste. I try to remind myself that what really matters is what I eat MOST of the time. The rest is a sunk cost and often a learning experience.

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Oct 22, 2023·edited Oct 22, 2023Liked by Annie Fenn, MD

Hi Annie - is there any type of charcuterie meat you would eat as a brain health expert and someone who travels and leads trips to Italy? Will you indulge in salami ever or prosciutto? If so- do you get it from a high-end butcher? What would you ask about it?

I do try to remember your mantras of moderation and not trying to beat myself up. It’s good to know you ate 10 cookies one day! #shesnormal

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Hi Liz! Great question. I try not to eat meat if I don't know where it's from. In Wyoming that is easy because I personally know the ranchers I purchase from. I know what they feed their animals and how they treat them. In Italy, I try to follow the same rule. During the retreats, we visit farms and meet the people growing and raising the food. We see how the animals live, what they eat. I have an immense amount of respect for these people and their craft. I do eat charcuterie in this setting because it has a few key differences from what we often see in the US. Instead of chemicals, food coloring, and sugar, they use herbs, spices and salt and sometimes bacterial cultures. Ultra processed meat applies heat which racks up AGE's. Artisanal charcuterie uses time. You can taste the difference, and you can even taste when the animal was fed chestnuts vs. pistachios. Plus, it's has historical and cultural signifance for the Italian people. There are butchers in the US doing the same good work. But most processed meat is in the form of hot dogs, bacon, Slim Jims, etc. and studies now show it is clearly linked to increased Alzheimer's risk.

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