Brain Health: Jeremy Denning of Dallas Neurosurgical & Spine On 5 Lifestyle Habits That Support Cognitive Well-Being

An Interview With Shawna Robins

Another lifestyle habit for me is a healthy and balanced diet, which I believe is extremely important. While I cannot say that I am even close to perfect in this endeavor, overall, I try to do things in moderation. My diet consists primarily of high protein, low fat and unprocessed carbohydrates, such as fruit and vegetables. Additionally, I have noticed that if I am well hydrated, my mental acuity and physical performance are significantly enhanced.

In a world inundated with distractions, constant connectivity, and a plethora of information, our cognitive well-being has never been more crucial. Amidst the clamor, how do we nurture our minds, keep our focus sharp, and cultivate habits that promote mental clarity? The right lifestyle habits can be the cornerstone to maintaining and even enhancing our cognitive abilities, ensuring not just longevity but also the quality of our mental faculties. As a part of this series, I had the pleasure of interviewing Jeremy Denning.

A board-certified and fellowship-trained neurosurgeon, Jeremy Denning, MD, has more than 20 years of experience treating patients. He is a practicing neurosurgeon with Dallas Neurosurgical & Spine and chief of the neurosurgery department at Baylor Scott & White Medical Center — Plano.

Thank you so much for doing this with us! Before we start, our readers would love to “get to know you” a bit better. Can you tell us a bit about your childhood backstory?

Yes, absolutely! I grew up on a ranch in a small, central Texas town, where the population was around 416 people. We raised and worked cattle on the ranch and grew peanuts, corn, and pecans. This experience really instilled in me the work ethic that I have today. Working on a ranch and farming is arduous work, but at the end of the day, there is an uplifting satisfaction that you feel having accomplished something … and it also makes one better appreciate working indoors, where there is air conditioning!

One evening, when I was in sixth grade, my grandfather had come home late from the cattle auction. As he was backing one of his horses out of the trailer, it accidentally kicked him in the head. He immediately, and briefly, lost consciousness. I witnessed it, and it scared me to death. We had to take him to the nearby hospital, which is about an hour and 20 minutes away. Dr. Wesley Wise took care of my grandfather in the emergency room. I remember watching Dr. Wise examine the x-rays of my grandfather ever so closely. It fascinated me that he could look at these films and figure out how to fix my grandfather. I remember at that moment wanting to be able to do the same thing for someone else, someday. I would later find out that Dr. Wise also owned a ranch and the local feed store and pretty much treated anything from a cough and cold to a surgical problem. Not only was he a wonderful doctor and clinician, but he also possessed a very special knack for engaging his patients and making them feel like they were special to him. To me, he was a hero, and someone I would try to emulate later in life.

Is there a particular book, podcast, or film that made a significant impact on you? Can you share a story or explain why it resonated with you so much? I read books and listen to podcasts frequently, and many of them have had a significant impact on me. One of the books I’m reading right now is called 100 Years of Solitude by a Colombian writer named Gabriel García Márquez. For me, reading is like food and a constant stimulus for my mind. It is both necessary and enjoyable.

Let’s now talk about lifestyle habits that support cognitive well-being. Are there specific foods or diets that have been scientifically shown to enhance cognitive functions?

Multiple factors affect cognitive health, such as age-related changes in the brain, injuries, mood disorders, substance abuse and diseases. Some of these cannot be altered. However, evidence exists of many possible modifiable lifestyle factors — including diet, physical activity, and cognitive and social engagement — which may stabilize or improve our cognitive health. In nutrition, the focus has been mainly on its role in brain development when we are young. There is currently a strong push to identify the role of diet and nutrition for prevention, treatment, or management of age-related disorders and maintaining quality of life among older adults. In general, high protein and low-fat diets are protective against cognitive decline. Several micronutrients like B group vitamins and iron, as well as many polyphenols, play a crucial role in cognitive health. Polyphenols are secondary metabolites of plants and comprise flavonoids (the most studied), lignans, stilbenes, coumarins and tannins. They are present abundantly in colorful fruits (berries, grapes, tomatoes), vegetables, tea, spices, herbs, and olive oil. They contribute to brain health similarly to antioxidants by regulating oxidative stress and mediating anti-inflammatory mechanisms. The World Health Organization recommends Mediterranean, Nordic, DASH, and MIND diets to lower the risk of cognitive decline and dementia. The MIND diet emphasizes leafy green vegetables, nuts, berries, beans, whole grains, seafood, poultry, olive oil and wine, while discouraging red meats, butter, cheese, sweets, and fried or fast food. One study found that participants most adherent to the MIND diet could slow cognitive aging by 7.5 years compared to those less adherent. An example of some healthy diet recommendations are as follows:

• Consider a Mediterranean-like healthy diet — fruits, vegetables, legumes (e.g., lentils, beans), nuts and whole grains (e.g., unrefined maize, millet, oats, wheat, brown rice).
• Every day, eat at least 400 g of fruit and vegetables. Potatoes, sweet potatoes, and other starchy root-vegetables don’t count!
• Less than 10% of your total energy intake should be from free sugars. This is equivalent to 50 g (or 10 teaspoons) for a person of healthy body weight, consuming approximately 2,000 calories per day. For additional health benefits, consume less than 5% (i.e., 25 g). Most free sugars are added to foods or drinks by the manufacturer, cook or consumer. They also occur naturally in honey, syrups, fruit juices and fruit juice concentrates.
• Less than 30% of your total energy intake should be from fats. Unsaturated fats ( such as fish, avocado, nuts, sunflower, canola and olive oils) are preferable to saturated fats (such as fatty meat, butter, palm and coconut oil, cream, cheese and ghee) and trans-fats of all kinds, including industrially produced trans-fats (processed or fried foods, cookies, biscuits, wafers, margarines, spreads, etc.) and ruminant trans-fats (meat and dairy foods from ruminant animals, such as cows, sheep and others). Reduce the intake of saturated fats to less than 10% of your total energy intake and trans-fats to less than 1%.

What are your thoughts on the importance of movement and exercise in the context of cognitive decline? How do different forms of exercise, such as aerobic vs. strength training, influence cognitive well-being?

When we refer to cognitive health, we often focus on the ability to recall events of the past and to process and learn new information. However, cognitive health also includes other aspects, such as acquiring motor/movement skills and the ability to apply these to complete a purposeful task in our daily activities. It is quite clear that physical exercise is a strong gene modulator that induces structural and functional changes in the brain, resulting in enormous benefit on both cognitive functioning and wellbeing. Furthermore, it is a protective factor for neurodegeneration. The positive biological effects include increases in cerebral blood flow, neurotransmitters such as serotonin and beta-endorphins, and a protein called brain-derived neurotrophic factor (BDNF). In addition to these biological changes, there are psychological benefits, including reduction in anxiety and depression and an increase in overall confidence and sense of well-being. While we may have been taught that genetics is a significant and unchangeable factor in overall health, there are several studies that strongly suggest exercise can modify our genes in a positive way for brain function and cognitive health. This newest area of research, called epigenetics, is garnering much more attention in its role in human adaptation and brain health. Any physical exercise, whether it be aerobic (such as jogging, cycling, or swimming), or anaerobic (such as weightlifting and resistance training) is better than none. In general, and regardless of intensity or duration, those who incorporate both aerobic and anaerobic activities experience better mental agility, quicker thinking, and greater ability to shift or adapt their thinking.

Can mindfulness practices or meditation offer measurable benefits to cognitive health?

Yes. Meditation and mindfulness practices have been found to have several benefits for cognitive health. Regular meditation can improve attention, focus, memory, and mental clarity. In addition, it can help reduce stress, anxiety, and depression, which can have a positive impact on cognitive function.

How does the quality and quantity of sleep correlate with cognitive performance and long-term brain health?

Sleep plays a crucial role in promoting brain health and mitigating age-related cognitive decline. We all know from personal experience that when we are sleep-deprived, our ability to concentrate and to process information is significantly impaired. Sleep supports memory, cognitive function, brain detoxification (glymphatic system), neuroplasticity, and emotional well-being. As one ages, the quantity of sleep that we require typically decreases. For example, newborns require 14 to 17 hours of sleep per day, while adults typically require 7 to 9 hours. One study of more than 28,000 adults found that participants who slept 13 to 14 hours exhibited an increased risk of memory impairment compared to those who regularly slept 7 to 8 hours.

The quality of sleep refers to how restful and rejuvenating your sleep is, and it is extremely important in our cognitive health. Strategies for improving sleep quality include maintaining a regular sleep schedule, creating a comfortable sleep environment, practicing relaxation techniques, avoiding stimulating activities before bed, and managing stress levels. Poor sleep also is associated with an increased risk of metabolic disorders, such as hypertension and elevated blood sugar, which are known contributors to cognitive aging. Prioritizing sufficient, quality sleep is important for maintaining optimal brain health throughout life.

How do social connections and interpersonal relationships influence our cognitive well-being?

Often when discussing cognitive health, the focus is on diet, exercise, and sleep. Often, we can improve these activities on our own. However, our social relationships also play a crucial role in influencing our cognitive well-being. They provide cognitive stimulation, emotional support, and social engagement, all of which contribute to better brain health and cognitive function. In addition, those who lack social engagement are at higher risk for the development of multiple diseases, early death, and negative brain health.

What role do lifelong learning and continuous mental stimulation play in maintaining optimal cognitive health?

Continuing to try to learn new things and skills is extremely important in maintaining and improving our cognitive health. It provides us with mental stimulation, which has been shown to lower our risk of developing age-related cognitive decline and dementia. Additionally, challenging the brain with new information and skills can help to build and strengthen neural connections, ultimately enhancing mental function. Lifelong learning activities — such as reading, learning a new language, solving puzzles, or taking up a new hobby — challenge our brains and help us to form new neural connections (neuroplasticity).

What are your five favorite lifestyle habits that proactively support cognitive well-being? Please share a story or an example for each, if you can.

1. As a physician and surgeon, time for myself is scarce. However, I strive to follow the advice that I give my patients. I have always enjoyed exercise and sports. Usually, I go to the gym 5 days a week for a mix of weightlifting and aerobic activities, such as running or cycling on my Peloton. I also recently incorporated swimming. In my personal experience, my day is much more focused and efficient if I have had some form of exercise before I go to work. Additionally, my quality of sleep is much improved. I also tend to eat healthier if I’ve worked out, and I’m in a much better mood (I think my wife would agree!).

2. Like I said earlier, I’m constantly reading about new things that interest me. One of the books I’m reading right now is about general relativity by Sean Carroll. I also really enjoy learning and experiencing new subjects through podcasts. It’s amazing how much information is at our disposal and how easy it is to access. I even picked up a new hobby (playing the piano) several years ago after watching a piano tutorial on YouTube. For me, the piano gives me a constant mental and fine motor skills challenge. It can be quite discouraging at times. However, I relish the challenge, as it also provides me with a sort of mental escape, where I can relax and close off many of the stressors and distractions of daily life.

3. Another lifestyle habit for me is a healthy and balanced diet, which I believe is extremely important. While I cannot say that I am even close to perfect in this endeavor, overall, I try to do things in moderation. My diet consists primarily of high protein, low fat and unprocessed carbohydrates, such as fruit and vegetables. Additionally, I have noticed that if I am well hydrated, my mental acuity and physical performance are significantly enhanced.

4. Finally, and no less significant for my overall cognitive health, are my social relationships. I am fortunate to have many wonderful relationships. I love people — and I think the fact that we are all different but also so similar at our core, is what makes our world so interesting and special. My wife and I emphasize the importance of sitting down with our four children for dinner every night, just to catch up in an ever fast-paced world. We are extremely close with the people we love, and we are grateful our home is never void of friends or family. In fact, I’m often a little disappointed if we are not getting together with friends or our family each week. I also have the luxury of engaging with people from all backgrounds each day in my clinic and I really enjoy getting to know them on a personal level. Relationships keep me going.

Are there any proven techniques or habits that can help protect against age-related cognitive decline?

Yes. There are things that people can do to help mitigate some of the age-related cognitive decline that we all will experience. As an example, these include constantly challenging our brain with tasks such as reading, learning new skills, solving puzzles, or playing musical instruments. As stated earlier, engaging in physical exercise not only benefits your body but also your brain. Studies have shown that regular exercise can improve cognitive function, memory, and overall brain health. We have all heard the saying, “you are what you eat.” Getting a well-balanced diet — rich in fruits, vegetables, whole grains, lean proteins, and healthy fats — is important for brain health. Include foods that are high in antioxidants, omega-3 fatty acids, and vitamins B, C, D, and E. These can help lessen oxidative damage in the brain that can occur over time. Aim for 7–9 hours of quality sleep each night, to support memory consolidation and overall brain health. Managing stress — such as practicing relaxation techniques, mindfulness, or engaging in activities you enjoy — is also important. In addition, maintaining social connections and engaging in social activities can lower your risk of cognitive decline.

In your professional or personal experience, what can be done to delay cognitive decline if the genetic predisposition is there?

The apolipoprotein E gene variant (APOE4) has the greatest effect on cognition past the age of 70. APOE4 is a well-established genetic risk factor for cognitive impairment and dementia. While this variant is an important genetic factor, it is not the sole determinant of cognitive aging risk, and a wide range of variants must be considered for a more comprehensive understanding. Furthermore, just because your genetics show an increased risk of cognitive aging does not mean you can’t delay cognitive decline. It’s never too late to adopt lifestyle modifications to delay cognitive aging. While starting young may be preferable, implementing positive lifestyle habits at any age can help slow cognitive aging. These lifestyle changes include many of the practices that we have mentioned above, such as constantly engaging and challenging our brain, healthy nutrition such as the MIND diet, sufficient and restful sleep, exercise, and staying socially engaged.

Is there a person in the world whom you would love to have lunch with, and why? Maybe we can tag them and see what happens!

If I could sit down with someone for lunch, it would be the pianist and songwriter Bruce Hornsby. I have always loved his music, ever since I first heard him on the radio when I was in junior high. He has such a unique style of music that incorporates elements of jazz, rock, and even classical music that creates such a distinctive sound. It really sets him apart.

How can our readers follow you online?

Readers can follow me on my website: http://dallasneurosurgical.com.

Thank you so much for sharing these important insights. We wish you continued success and good health!

About the Interviewer: Shawna Robins is an international best-selling author of two books — Powerful Sleep — Rest Deeply, Repair Your Brain and Restore Your Life, and Irresistibly Healthy — Simple Strategies to Feel Vibrant, Alive, Healthy and Full of Energy Again. Shawna is the founder and CEO of Third Spark, an online wellness hub for women over 40 who want to reignite their sleep, reset healthier habits and respark their lives. Shawna is a sleep expert, hormone health expert, and a National Board-Certified Health and Wellness Coach (NBHWC). She has been featured on many podcasts including Dr. Mindy Pelz’s “The Resetter Podcast” and in Authority Magazine, Thrive Global, and The Huffington Post. A free download of her latest book can be found at www.thirdsparkhealth.com/powerful-sleep/ You can follow her on YouTube, Facebook, Instagram and LinkedIn.