Women’s Health
Squaring the Circle of Lifestyle, Dementia, Diabetes and Epigenetics
According to the World Health Organization, 55 million people globally are impacted by dementia,
with an estimated 10 million increase every year [1]. Women are more likely to get dementia, with
women being 2 in 3 of those diagnosed [2]. Diabetes is another chronic illness that affects 1 in 9
women [3]. Epigenetic studies which help explain the role of environment in influencing your genes,
provides evidence of how lifestyle habits play a major role in these diseases. These genetic changes
can be permanent and carried on to the next generation. Dementia and diabetes have a genetic
connection, and environmental factors can affect gene function governing these illnesses. Despite
the severity of these disorders, it is possible to greatly lower the risk by implementing healthier
lifestyle changes.
Diabetes and dementia: what are the risk factors?
Diabetes and dementia, like many other chronic diseases have similar risk factors and are
interlinked. Their connection is well established to the extent that Alzheimer’s (most common type
of dementia) is also called Type 3 diabetes [4]. In fact, being diabetic increases the risk of Alzheimer’s
by over 50% [5].
Apart from family history, some common risk factors like obesity, high blood pressure, high
cholesterol, lack of physical activity, and poor dietary choices can increase the risk of diabetes and
dementia. The good news is that these risk factors can be managed to greatly reduce your chance of
getting these disorders.
Diabetes and dementia: How can you protect yourself?
The Women’s Brain Health Initiative (WBHI) is a foundation formed in the USA and Canada and
focuses on improving women’s cognitive health. They recommend 6 areas that must be focused on
to improve brain health: nutrition, exercise, sleep, stress management, keeping your brain active,
and having a social network. You can easily implement these to reap big benefits and live a healthier
life to reduce your risk of diabetes and dementia:
1. Eat right for a healthier body and brain.
You are what you eat. It might be overwhelming to follow every new diet that promises miracles.
There is one diet that is well evidenced to decrease the risk of diabetes and dementia. The
Mediterranean diet has shown to reduce the risk of diabetes by 19-23% [6] and of Alzheimer’s by
almost 40% [7].
The Mediterranean diet is the diet that is local to areas like Turkey, Greece, Italy, Morocco, Spain
and surrounding areas. This traditional diet emphasizes increased intake of whole grains, beans and
legumes, fruits and vegetables, fish and olive oil. It encourages limiting intake of red meat and
sweets. A more advanced version of this diet is the MIND (Mediterranean-DASH Diet Intervention
for Neurodegenerative Delay) diet if you are looking to maximize your health benefits. Studies show
that long term adherence to the MIND diet will lower the risk of Alzheimer’s by 53% [8]. The
nutrients in this diet also help establish good blood sugar balance. The MIND diet has clear
recommendations on 10 foods that are beneficial and a few foods that are unhealthy and must be
limited. MIND diet recommendations include [8]:
Green leafy vegetables: >6 servings a week
Nuts: ≥5 servings a week
Other vegetables: >1 serving a day
Whole grains: ≥3 servings a day
Berries: ≥2 servings a week
Beans: >3 meals a week
Fish (not fried): ≥1 meals a week
Poultry like chicken (not fried): ≥2 meals a week
Olive oil: Main oil to be used
Foods like butter, margarine, cheese, red meat, fried foods, and sweets should be limited as follows:
Butter, Margarine: <1 tablespoon per day
Cheese: <1 serving a week
Red meat: <4 meals a week
Fried foods: <1 time a week
Sweets: <5 servings a week
2. Exercise to for a fitter body and brain.
Increasing your physical activity levels is one of the best lifestyle modifications you can make to
improve your health long term. In fact, a major review listed exercise as a treatment therapy for
over 26 diseases, including dementia and diabetes [9]. You don’t have to spend hours in the gym to
get the most out of exercise. Even a simple activity such as walking can provide health benefits.
Starting out with just 3800 steps a day can lower your dementia risk by 25% [10]. In addition, those
who did moderate intensity exercise for 150 minutes/week as part of their lifestyle modifications,
had a 58% lower risk of getting diabetes [11]. A study that spanned over 4 decades looked at the
lives of women between the ages of 38-60 years. Women who topped the fitness charts had an
almost 90% lower risk of getting Alzheimer’s [12]. Exercising helps your body use blood glucose more
effectively and keeping it balanced- an important aspect in diabetes. This was seen in women who
exercised 3 times a week at a moderate-vigorous intensity [13].
3. Sleep well for relaxed body and brain.
Getting a good quality sleep essential for a healthy body. Your brain is working hard while you sleep
to promote good health. In fact, getting less sleep (under 7-8 hours) can increase the risk of diabetes
by 40% [14]. As for brain health, your brain is busy cleaning up waste materials and organizing and
storing memories and important information while you sleep. Getting adequate sleep is protective
towards dementia. A study among older women found that there was a 30% higher risk of dementia
among women who regularly slept for less than 6 hours [15]. The Alzheimer’s Association
recommends some tips to improve sleep quality: establish regular sleep time by sleeping and waking
up at the same time, have a good sleep hygiene routine, and avoid stimulants like caffeine and
screen time before bed [16].
4. Manage your stress for a rejuvenated body and brain.
Constantly being under high levels of stress can be detrimental to your body and brain. Women who
regularly suffered from moderate-to-high levels of stress had a higher risk of getting diabetes after 3
years [17]. Similarly, middle aged women who were under a high level of stress often had around
20% higher risk of developing dementia in their 70s [18]. When your stress hormone is consistently
high, there is increased levels of brain chemicals associated with Alzheimer’s disease [18]. There are
many stress-management techniques that you can incorporate in your daily life to effectively
manage it. Even a simple activity like spending 20-30 minutes in nature, 3 times per week can
decrease your stress hormone by 20%, [20] and thus the risk of dementia and diabetes. Finding
enjoyable activities that help you relax and managing your day correctly can greatly reduce stress
levels.
5. Keep your brain active to stay protected.
Keeping your brain mentally stimulated can help preserve brain function. This is even true among
those who were diabetic. Mentally stimulating activities reduced the risk dementia and of diabetes-
damage in those who developed dementia [21]. Having hobbies like knitting, reading, volunteering,
playing board games etc can greatly lower the risk of dementia. Women their 30 and 40s who
partook in intellectual activities had a 38% lower risk getting dementia in old age [26]. Pick up a new
hobby like drawing, learning a new language, playing a musical instrument to help your brain form
strong connections and brain cells that can protect it in old age.
6. Build your social network for a nourished body and brain.
Have a strong social network of family and good friends can do wonders for your physical and
mental health. In fact, those who were lonely were twice more likely to develop diabetes than those
who had a good support system [23]. Being more social and meeting your friends regularly is
protective towards your brain as well. Older women who had a large social network where they met
their friends and family more than once a month, had a 26% lower risk of dementia [24]. Community
clubs, volunteers or joining a hobby group are some great ways to make new friends while mentally
stimulating your brain for added benefits, making it a win-win situation.