Archives February 2024

Americans love their ultra-processed foods, whether they come as cereal (like Cap’n Crunch, a favorite of mine as a kid), snack foods (like Cheetos), entr’es (like hot dogs), or desserts (like Twinkies). Sure, loading your plate with vegetables, fruits, fish, healthful oils, and grains in a Mediterranean-style diet boosts heart and brain health. But if you also eat some ultra-processed foods, is that bad for your brain health?

What to know about this new study

A new study appears to deliver resounding yes: eating ultra-processed foods is linked to a greater risk of cognitive impairment and strokes.

This well-designed observational study examined data from the REGARDS (REasons for Geographic And Racial Differences in Stroke) project, a longitudinal study of non-Hispanic Black and white Americans ages 45 years and older. Study participants were initially enrolled between 2003 and 2007 and were given a number of questionnaires evaluating health, diet, exercise, body mass index, education, income, alcohol use, mood, and other factors. In addition, tests of memory and language were administered at regular intervals.

To examine the risk of stroke and cognitive impairment, data from 20,243 and 14,175 participants, respectively, were found usable based on the quality of the information from the questionnaires and tests. Approximately one-third of the sample identified as Black and the majority of the remaining two-thirds identified as white.

The results of the study

• According to the authors’ analysis, increasing the intake of ultra-processed foods by just 10% was associated with a significantly greater risk of cognitive impairment and stroke.
• Intake of unprocessed or minimally processed foods was associated with a lower risk of cognitive impairment.
• The effect of ultra-processed foods on stroke risk was greater for individuals who identified as Black compared to individuals who identified as white.

Study participants who reported following a healthy diet (like a Mediterranean, DASH, or MIND diet) and consumed minimal ultra-processed foods appeared to maintain better brain health compared to those who followed similar healthy diets but had more ultra-processed foods.

Why might ultra-processed foods be bad for your brain?

Here are some biologically plausible reasons:

• UPFs are generally composed of processed carbohydrates that are very quickly broken down into simple sugars, equivalent to eating lots of candy. These sugar loads cause spikes of insulin, which can alter normal brain cell function.
• Eating ultra-processed foods is associated with a higher risk of metabolic syndrome and obesity, well-established conditions linked to high blood pressure, abnormal blood lipid levels, and type 2 diabetes.
• There are unhealthy additives in ultra-processed foods to change the texture, color, sweetness, or flavor. These additives disrupt the microbiome in the gut and can lead to gut inflammation that can cause
  • the production of microbiome-produced metabolites that can affect brain function (such as short-chain fatty acids and lipopolysaccharides)
  • leaky gut, allowing toxins and inflammatory molecules to enter the bloodstream and go to the brain
  • altered neurotransmitter function (such as serotonin) that can impact mood and cognition directly
  • increased cortisol levels that mimic being under chronic stress, which can directly impact hippocampal and frontal lobe function, affecting memory and executive function performance, respectively
  • an increased risk for Alzheimer’s, Parkinson’s, and other neurodegenerative diseases due to inflammatory molecules traveling from the gut to the brain.
• Because ultra-processed foods have poor nutritional value, people will often be hungry shortly after eating them, leading to overeating and its consequences.

The take-home message

Avoid processed foods, which can include chips and other snack foods, industrial breads and pastries, packaged sweets and candy, sugar-sweetened and diet sodas, instant noodles and soups, ready-to-eat meals and frozen dinners, and processed meats such as hot dogs and bologna. Eat unprocessed or minimally processed foods, which — when combined with a healthy Mediterranean menu of foods — include fish, olive oil, avocados, whole fruits and vegetables, nuts and beans, and whole grains.

About the Author

Andrew E. Budson, MD, Contributor; Editorial Advisory Board Member, Harvard Health Publishing

Dr. Andrew E. Budson is chief of cognitive & behavioral neurology at the Veterans Affairs Boston Healthcare System, lecturer in neurology at Harvard Medical School, and chair of the Science of Learning Innovation Group at the … See Full Bio View all posts by Andrew E. Budson, MD

When you live in a coastal area, preparing early for potential hurricanes is a must. Storms can develop quickly, leaving little time to figure out where you’ll be safe or which items to pack if you have to evacuate. And health care necessities, such as medications or medical equipment, are often overlooked in the scramble.

“People might bring their diabetes medication but forget their blood sugar monitor, or bring their hearing aids but forget extra batteries for them,” says Dr. Scott Goldberg, medical director of emergency preparedness at Brigham and Women’s Hospital and a longtime member of a FEMA task force that responds to hurricane-damaged areas.

Here’s some insight on what to expect this hurricane season, and how to prioritize health care in your hurricane kit.

What will the 2024 hurricane season look like?

This year’s hurricane predictions underscore the urgency to start preparations now.

Forecasters with the National Oceanic and Atmospheric Administration’s National Weather Service expect above-normal activity for the 2024 hurricane season (which lasts until November 30).

Meteorologists anticipate 17 to 25 storms with winds of 39 mph or higher, including eight to 13 hurricanes — four to seven of which could be major hurricanes with 111 mph winds or higher.

What kinds of plans should you make?

Preparing for the possibility of big storms is a major undertaking. Long before ferocious winds and torrential rains arrive, you must gather hurricane supplies, figure out how to secure your home, and determine where to go if you need to evacuate (especially if you live in a flood zone). Contact the emergency management department at your city or county for shelter information.

If you’ll need help evacuating due to a medical condition, or if you’ll need medical assistance at a shelter, find out if your county or city has a special needs registry like this one in Florida. Signing up will enable first responders to notify you about storms and transport you to a special shelter that has medical staff, hospital cots, and possibly oxygen tanks.

What should you pack?

While a shelter provides a safe place to ride out a storm, including bathrooms, water, and basic meals, it’s up to you to bring everything else. It’s essential to pack medical equipment and sufficient medications and health supplies.

“It’s natural to just grab the prescription medications in your medicine cabinet, but what if it’s only a two-day supply? It might be a while before you can get a refill. We recommend at least a 14-day or 30-day supply of every prescription,” Dr. Goldberg says. “Talk to your doctor about the possibility of getting an extra refill to keep on standby for your go bag.”

Other health-related items you’ll want to pack include:

• medical supplies you use regularly, such as a blood pressure monitor, heart monitor, CPAP machine, wheelchair, or walker
• over-the-counter medicines you use regularly, such as heartburn medicine or pain relievers
• foods for specific dietary needs, such as gluten-free food if you have celiac disease (if you have infants or children, you’ll need to bring foods they can eat)
• healthy, nonperishable snacks such as nuts, nut butters, trail mix, dried fruit, granola bars, protein bars, and whole-grain bread, crackers, or cereals
• hygiene products such as soap, hand sanitizer, toothbrushes and toothpaste, shampoo, deodorant, infant or adult diapers, lip balm, moist towelettes, and toilet paper — because shelters often run out of it.

Remember the basics

In some ways, you can think of shelter living like camping. You’ll need lots of basic supplies to get through it, including:

• a sleeping bag or blanket and pillow for each person in your family
• clean towels and washcloths
• a few extra changes of clothes per person
• a first-aid kit
• flashlights and extra batteries
• chargers for your electronic gadgets
• rechargeable battery packs.

Bring important paperwork

In addition to supplies, bring important documents such as:

• a list of your medications, vitamins, and supplements (include the name, dose, and frequency of each one)
• a list of the names, addresses, and phone numbers of your primary care provider and any specialists who treat you
• a list of your emergency contacts and their phone numbers
• your pharmacy’s phone number and address
• copies of your birth certificate and driver’s license
• copies of home, car, or life insurance policies
• copies of your health insurance cards
• a copy of your advance directive — which includes your living will and health care proxy form.

“Store these documents on a flash drive. Also make photocopies of them, which are easiest for doctors to consult in an emergency setting. Place them in a plastic zip-top bag to keep them dry,” Dr. Goldberg advises.

Prepare right now

Start today. Gather as many go-bag supplies as you can, including the bags. A small suitcase, backpack, or duffel bag for each person in your family will work well.

And try not to put off these important preparations. “Hurricanes are major stressors. You might be worried, sleep deprived, fatigued, and emotional,” Dr. Goldberg says. “All of that will make it hard to think clearly. You’ll do yourself and your family a favor by having discussions now and getting started on your hurricane plan.”

About the Author

Heidi Godman, Executive Editor, Harvard Health Letter

Heidi Godman is the executive editor of the Harvard Health Letter. Before coming to the Health Letter, she was an award-winning television news anchor and medical reporter for 25 years. Heidi was named a journalism fellow … See Full Bio View all posts by Heidi Godman

About the Reviewer

Howard E. LeWine, MD, Chief Medical Editor, Harvard Health Publishing

Dr. Howard LeWine is a practicing internist at Brigham and Women’s Hospital in Boston, Chief Medical Editor at Harvard Health Publishing, and editor in chief of Harvard Men’s Health Watch. See Full Bio View all posts by Howard E. LeWine, MD